Hannah Nystrom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2720 Issued in NV

Practice address

1200 Mountain St Ste 230
Carson City, NV 89703-3867

Phone

(775) 882-1324

Fax

(775) 882-3859

NPI assigned

Nov 7, 2022

Last updated

Nov 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fallon Tribal Health Center

  • Clinic/Center
  • Fallon, NV
  • NPI 1023057478
  NPD (past)

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1932817160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MOUNTAIN ST STE 230",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033867",
            "telephone_number": "775-882-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MOUNTAIN ST STE 230",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033867",
            "telephone_number": "775-882-1324",
            "fax_number": "775-882-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "HANNAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Nevada Sleep and Wellness Inc
• Cynthia Novak, MD
• Kerry W. Novak, MD
• Viola Elizabeth Nungary, M.F.T.
• Nvohc LLC (North Carson Physical Therapy)
• Cynthia O, LMT, CLT
• Bonnie J O'Daye
• Glinda Rebecca Marie O'Donnell, PRSS
• Susan Lane O'Leary, MD
• Peter O'Reilly, PA-C

• Physician Assistant in Carson City, NV
• Providers in Carson City, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.