Active NPI
Elvanson Rovincer Nantongo, PHARM.D
- Pharmacist
- Fallon, NV
National Provider Identifier
1942270475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD10098
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PD10098 | AR | MD | Pharmacist |
| 17564 | NV | MD | Pharmacist |
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.