Individual provider Active NPI

John Paul Bacaltos Mercado, N.P.

  • Family Nurse Practitioner
  • Reno, NV
National Provider Identifier
1891144374
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002196 Issued in NV
Practice address
18653 Wedge Pkwy
Reno, NV 89511-3323
Phone
(775) 770-7210
Fax
(775) 770-7211
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN62564 NV
Family Nurse Practitioner 363LF0000X APRN002196 NV Primary

Addresses

Primary practice location

18653 Wedge Pkwy
Reno, NV 89511-3323

Mailing address

411 W 6TH St
Reno, NV 89503-4415
Phone (775) 770-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908000967 NV Practitioner - Nurse Practitioner 1850687476 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN62564NVMDRegistered Nurse
APRN002196NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards MD PC CurrentSince Dec 3, 2024 Accepting new patients
Shadow Emergency Physicians PLLC Nurse Practitioner CurrentSince May 23, 2018 Accepting new patients
Eds-I Homansky Practices of Nevada PC Nurse Practitioner CurrentSince Nov 2, 2022 Accepting new patients
Shadow Emergency Physicians PLLC Nurse Practitioner CurrentSince May 23, 2018 Accepting new patients
Eds-I Homansky Practices of Nevada PC Nurse Practitioner CurrentSince Nov 2, 2022 Accepting new patients

Locations

1155 Raiders Way
Henderson, NV 89052
Phone (702) 369-7671

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

360 S Lola Ln
Pahrump, NV 89048
Phone (775) 751-7500

1511 Oppio Ranch Pkwy
Sparks, NV 89436
Phone (775) 567-5400

13737 Noel Rd
Ste 1600
Dallas, TX 75240
Phone (214) 712-2489

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1891144374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W 6TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034415",
            "telephone_number": "775-770-7600",
            "fax_number": "775-770-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18653 WEDGE PKWY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113323",
            "telephone_number": "775-770-7210",
            "fax_number": "775-770-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "JOHN PAUL",
        "middle_name": "BACALTOS",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN62564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.