Organization Active NPI

Blizz, Inc

  • Internal Medicine Physician
  • Reno, NV
National Provider Identifier
1861031569
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BLIZZ, INC
Practice address
14235 Eagle Springs CT
Reno, NV 89511-6773
Phone
(850) 687-9608
NPI assigned
Dec 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Mr. Robert Conner
Title
Consultant
Phone
(775) 721-0457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

14235 Eagle Springs CT
Reno, NV 89511-6773

Mailing address

14235 Eagle Springs CT
Reno, NV 89511-6773

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200418000024 NV Part B Supplier - Clinic/Group Practice 5799115580 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Locations

35 West St
Fernley, NV 89408
Phone (775) 391-9778

Practitioners & affiliated clinicians

Practitioners 2

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": "1577404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1861031569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14235 EAGLE SPRINGS CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895116773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14235 EAGLE SPRINGS CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895116773",
            "telephone_number": "850-687-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLIZZ, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-27",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "775-721-0457",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Apr 20, 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.