Northern Nevada Medical Supply, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

MP00387 Issued in NV

Legal business name

NORTHERN NEVADA MEDICAL SUPPLY, LLC

Practice address

1395 Greg St
Suite 102
Sparks, NV 89431-6073

Phone

(775) 824-9911

Fax

(775) 824-9910

NPI assigned

Jul 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Doug Catton

Title

Managing Member

Phone

(775) 824-9911

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1700819786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 GREG ST",
            "address_2": "SUITE 102",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894316073",
            "telephone_number": "775-824-9911",
            "fax_number": "775-824-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 GREG ST",
            "address_2": "SUITE 102",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894316073",
            "telephone_number": "775-824-9911",
            "fax_number": "775-824-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEVADA MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "CATTON",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "775-824-9911"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NV",
            "license": "MP00387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510205",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Sparks, NV
• Providers in Sparks, NV by specialty
• Customized Equipment (DME) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.