Active NPI
John H Dudley, DC
- Chiropractor
- Reno, NV
National Provider Identifier
1881608396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- B308
- Practice address
- 1595 Lakeside Dr
Reno, NV 89509 - Phone
- (775) 323-4660
- Fax
- (775) 323-4678
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | B308 | NV | Primary |
Addresses
Primary practice location
1595 Lakeside Dr
Reno, NV 89509
Mailing address
1595 Lakeside Dr
Reno, NV 89509
Phone (775) 323-4660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050322000951 | NV | Practitioner - Chiropractic | 5496701518 | Practice locations: Reno, NV |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1984
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1595 Lakeside Dr
Reno, NV 89509-3461
Phone (775) 323-4660
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B308 | NV | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1881608396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1595 LAKESIDE DR",
"city": "RENO",
"state": "NV",
"postal_code": "89509",
"telephone_number": "775-323-4660",
"fax_number": "775-323-4678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 LAKESIDE DR",
"city": "RENO",
"state": "NV",
"postal_code": "89509",
"telephone_number": "775-323-4660",
"fax_number": "775-323-4678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "JOHN",
"middle_name": "H",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NV",
"license": "B308",
"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 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.