Active NPI
Nicholas John Anderson
- Perfusionist
- Reno, NV
National Provider Identifier
1760109060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- LP133
- Practice address
- 1155 Mill St
Reno, NV 89502-1576 - Phone
- (775) 982-4100
- NPI assigned
- Oct 26, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | LP133 | NV | Primary |
Addresses
Primary practice location
1155 Mill St
Reno, NV 89502-1576
Mailing address
13316 S Lake Forest Dr
Draper, UT 84020-7849
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP133 | NV | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1760109060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13316 S LAKE FOREST DR",
"city": "DRAPER",
"state": "UT",
"postal_code": "840207849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 MILL ST",
"city": "RENO",
"state": "NV",
"postal_code": "895021576",
"telephone_number": "775-982-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "NICHOLAS",
"middle_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "NV",
"license": "LP133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.