Individual provider Active NPI

Stacy Berlekamp Spatar, NP-C

  • Nurse Practitioner
  • Reno, NV
National Provider Identifier
1740622240
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
829333 Issued in NV
Practice address
9990 Double R Blvd Ste 200
Reno, NV 89521-4833
Phone
(775) 348-8800
Fax
(775) 348-8818
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 829333 NV Primary

Addresses

Primary practice location

9990 Double R Blvd Ste 200
Reno, NV 89521-4833

Mailing address

5310 Kietzke LN Ste 104
Reno, NV 89511-2043
Phone (775) 348-8800

Other identifiers 1

IdentifierTypeStateIssuer
250008105MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200529001972 NV Practitioner - Nurse Practitioner 2365676756 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
829333NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Berman & Mack LTD. CurrentSince Aug 16, 2021 Accepting new patients
James J Lynch MD LTD CurrentSince May 1, 2022 Accepting new patients
James J Lynch M D LTD CurrentSince May 1, 2022 Accepting new patients

Locations

1470 Medical Pkwy
Ste 220
Carson City, NV 89703

9990 Double R Blvd
Ste 200
Reno, NV 89521
Phone (605) 999-7267

605 Sierra Rose Dr
Ste 4
Reno, NV 89511
Phone (775) 689-5410

5310 Kietzke Ln
Ste 104
Reno, NV 89511

Interoperability endpoints

  • Direct secure messaging: sberlekampspatar189140@direct.renown.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1740622240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 KIETZKE LN STE 104",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112043",
            "telephone_number": "775-348-8800",
            "fax_number": "775-348-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 DOUBLE R BLVD STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214833",
            "telephone_number": "775-348-8800",
            "fax_number": "775-348-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLEKAMP SPATAR",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "829333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250008105",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.