NPIMap

Organization Active NPI

Clark W Pillsbury, DPM, LLC

  • Podiatrist
  • Reno, NV
National Provider Identifier
1760667935
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
8801 Issued in NV
Legal business name
CLARK W PILLSBURY, DPM, LLC
Practice address
10463 Double R Blvd
Suite 100
Reno, NV 89521-8908
Phone
(775) 358-2542
Fax
(775) 358-1413
NPI assigned
Jan 7, 2008
Last updated
Apr 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Dr. Clark W Pillsbury, D.P.M.NPI 1467526509
Title
President
Phone
(775) 358-2542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 8801 NV Primary

Addresses

Primary practice location

10463 Double R Blvd
Suite 100
Reno, NV 89521-8908

Mailing address

10463 Double R Blvd
Suite 100
Reno, NV 89521-8908
Phone (775) 358-2542

Other identifiers 1

IdentifierTypeStateIssuer
002116004MedicaidNV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1760667935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10463 DOUBLE R BLVD",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218908",
            "telephone_number": "775-358-2542",
            "fax_number": "775-358-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10463 DOUBLE R BLVD",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218908",
            "telephone_number": "775-358-2542",
            "fax_number": "775-358-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK W PILLSBURY, DPM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PILLSBURY",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-358-2542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "8801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002116004",
            "state": "NV"
        }
    ],
    "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 Apr 15, 2008; 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.