Individual provider Active NPI

Elvanson Rovincer Nantongo, PHARM.D

  • Pharmacist
  • Fallon, NV
National Provider Identifier
1942270475
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD10098 Issued in AR
Practice address
Naval Branch Health Clinic Nas Fallon BLDG 299
4755 Pasture Road
Fallon, NV 89496-5000
Phone
(775) 426-3122
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD10098 AR Primary
Pharmacist 183500000X 17564 NV

Addresses

Primary practice location

Naval Branch Health Clinic Nas Fallon BLDG 299
4755 Pasture Road
Fallon, NV 89496-5000

Mailing address

1204 E Front St
Fallon, NV 89406-6110
Phone (775) 426-8431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD10098ARMDPharmacist
17564NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1942270475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 E FRONT ST",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894066110",
            "telephone_number": "775-426-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL BRANCH HEALTH CLINIC NAS FALLON BLDG 299",
            "address_2": "4755 PASTURE ROAD",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894965000",
            "telephone_number": "775-426-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANTONGO",
        "first_name": "ELVANSON",
        "middle_name": "ROVINCER",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10098",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "17564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallon, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.