Organization Active NPI

Lisa G Abbott MD a Professional Corporation

  • Medical Specialty Clinic/Center
  • Reno, NV
National Provider Identifier
1760671887
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
6743 Issued in NV
Legal business name
LISA G ABBOTT MD A PROFESSIONAL CORPORATION
Practice address
665 Sierra Rose Dr
Reno, NV 89511-2060
Phone
(775) 786-6770
Fax
(775) 786-4901
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Lisa G Abbott, M.D.NPI 1609883701
Title
MD
Phone
(775) 786-6770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 6743 NV Primary

Addresses

Primary practice location

665 Sierra Rose Dr
Reno, NV 89511-2060

Mailing address

4265 Ross Dr
Reno, NV 89519-2945
Phone (775) 786-6770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071022000525 NV Part B Supplier - Clinic/Group Practice 3173619111 Receives reassigned benefits from 4 practitioners
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Locations

540 W Plumb Ln
Ste 201
Reno, NV 89509
Phone (775) 786-6770

665 Sierra Rose Dr
Reno, NV 89511
Phone (775) 786-6770

540 W Plumb Ln
#2B
Reno, NV 89509
Phone (775) 786-6770

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1760671887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 ROSS DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895192945",
            "telephone_number": "775-786-6770",
            "fax_number": "775-786-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 SIERRA ROSE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-786-6770",
            "fax_number": "775-786-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA G ABBOTT MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "775-786-6770",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NV",
            "license": "6743",
            "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 Jan 21, 2020; 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.