Active NPI
Adam Tully Mick, P.T.
- Physical Therapist
- Reno, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 35436
- Practice address
- 9990 Double R Blvd Ste 200
Reno, NV 89521-4833 - Phone
- (775) 348-8800
- Fax
- (775) 348-8818
- NPI assigned
- Mar 8, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1538 | NV | |
| Physical Therapist | 225100000X | 35436 | CA | Primary |
Addresses
Primary practice location
9990 Double R Blvd Ste 200
Reno, NV 89521-4833
Mailing address
5310 Kietzke LN Ste 104
Reno, NV 89511-2043
Phone (775) 348-8800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 90.71 of 100
- Quality
- 81.42
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35436 | CA | MD | Physical Therapist |
| 1538 | NV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James J Lynch MD LTD | Current | Accepting new patients | |
| James J Lynch M D LTD | Current | Accepting new patients | |
| Ross E. Waltz PT | Physical Therapist | Past | Accepting new patients |
Locations
1470 Medical Pkwy
Ste 220
Carson City, NV 89703
1465 S Meadows Pkwy
Reno, NV 89521
Phone (775) 348-8885
9990 Double R Blvd
Ste 200
Reno, NV 89521
Phone (753) 488-8008
5310 Kietzke Ln
Ste 104
Reno, NV 89511
780 Vista Blvd
Ste 100
Sparks, NV 89434
Phone (753) 348-8800
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Carson City, NV
- NPI 1669157319
-
- Specialist
- Reno, NV
- NPI 1285649608
-
- Physical Therapist
- Reno, NV
- NPI 1972604122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1881662765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5310 KIETZKE LN STE 104",
"city": "RENO",
"state": "NV",
"postal_code": "895112043",
"telephone_number": "775-348-8800",
"fax_number": "775-348-8818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9990 DOUBLE R BLVD STE 200",
"city": "RENO",
"state": "NV",
"postal_code": "895214833",
"telephone_number": "775-348-8800",
"fax_number": "775-348-8818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICK",
"first_name": "ADAM",
"middle_name": "TULLY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "1538",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "35436",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1900 Dresden Dr",
"city": "Lincoln",
"state": "CA",
"country_code": "US",
"postal_code": "956488803",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.