NPIMap

Organization Active NPI

Northeastern Nevada Physician Practices LLC

  • Family Medicine Physician
  • Elko, NV
National Provider Identifier
1730408949
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHEASTERN NEVADA PHYSICIAN PRACTICES LLC
Practice address
1995 Errecart Blvd
Suite 203
Elko, NV 89801-8346
Phone
(775) 777-2061
Fax
(775) 777-2067
NPI assigned
May 27, 2010
Last updated
Sep 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Urology Physician 208800000X

Addresses

Primary practice location

1995 Errecart Blvd
Suite 203
Elko, NV 89801-8346

Mailing address

1995 Errecart Blvd
Suite 203
Elko, NV 89801-8346
Phone (775) 777-2061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090306000555 NV Part B Supplier - Clinic/Group Practice 3779649223 Receives reassigned benefits from 47 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elko, NV
O20251110003588 AZ Part B Supplier - Clinic/Group Practice 3779649223 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7059 N Oracle Rd
Tucson, AZ 85704
Phone (775) 738-5151

1775 Browning Way
Ste 201
Elko, NV 89801
Phone (775) 777-3535

1995 Errecart Blvd
Ste 102
Elko, NV 89801
Phone (775) 738-3111

1995 Errecart Blvd
Ste 201
Elko, NV 89801
Phone (775) 738-4477

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1730408949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD",
            "address_2": "SUITE 203",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018346",
            "telephone_number": "775-777-2061",
            "fax_number": "775-777-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD",
            "address_2": "SUITE 203",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018346",
            "telephone_number": "775-777-2061",
            "fax_number": "775-777-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN NEVADA PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.