Nevada Health Centers, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Reno, NV
NPI 1952009151 · NPPES record last updated Feb 17, 2023
Key facts
- NPI
- 1952009151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- NEVADA HEALTH CENTERS, INC.
- Practice address
- 790 Willow St
Reno, NV 89502-1304 - Phone
- (775) 887-5140
- NPI assigned
- Feb 17, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- NEVADA HEALTH CENTERS, INC.
Authorized official
- Name
- Carrie Black
- Title
- Provider Relations Manager
- Phone
- (775) 888-6610
Owners & managing parties with NPI records 24
Owned or controlled facilities with NPI records 13
Other NPIs on the same Medicare enrollment 34
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 33
Facilities with the same owner 13
Practitioners 39
-
Steven H Cerna, APRN
-
Madelaine Heidi Coquelet-Meyer, MFT, LCADC
-
Sarah Draves, APRN
-
Ashwitha Francis, MD
-
Rachel Elizabeth Grant, FNP-C
-
Gayle Harris, APRN
-
Amanda Lauren Horton, APRN
-
Mylinda Barrick Houser, LCSW
-
Sandra Fay Lewis, LCSW
-
Steve Lore, MD
-
Karina J Luera, DO
-
Elyse Muratore, MD
-
Ertha A Nanton, MD
-
Michael W Owens, MD
-
Amol Patel, MD
-
Rhianna Michelle Perez, MSN, FNP-C
-
Darren A Rahaman, MD
-
Jill Rathie, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2278951 | Willow Street Health Center | Certificate of waiver | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Federally qualified health center certification: CCN 291009
- Legal name
- NEVADA HEALTH CENTERS INC
- Doing business as
- WILLOW STREET HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 11, 2023
- Last certification
- Oct 11, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 22, 1992 in NV
- Enrollment address
- 790 Willow St BLDG
Reno, NV 89502-1304
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Alan Herak |
Corporate Director |
Jul 1, 2023 | |
| Donald E Chaney |
Corporate Director |
Jun 1, 2013 | |
| Timothy Blakely |
Corporate Director |
Jun 1, 2018 | |
| Lyn Beggs |
Corporate Director |
Jun 1, 2022 | |
| Jeff Snyder |
Corporate Director |
Jun 1, 2017 | |
| Alicia Y Barnes |
Corporate Director |
Jun 1, 2013 | |
| Gerald Ackerman |
Corporate Director |
Jun 1, 2012 | |
| Tom Zumtobel |
Corporate Director |
Jun 1, 2022 | |
| Linda Bingaman |
Corporate Director |
Jun 1, 2012 | |
| Kathryn L Triplett |
Corporate Officer |
Oct 3, 2016 | 50% |
| W-2 Managing Employee |
Oct 3, 2016 | 50% | |
| Nevada Health Centers Inc |
5% Or Greater Direct Ownership Interest | Aug 22, 2023 | 100% |
| Maurice Washington |
Corporate Director |
Jun 1, 2014 | |
| Jared Carter |
Corporate Director |
Jun 1, 2009 | |
| Walter B Davis |
Corporate Officer |
Nov 26, 2012 | 50% |
| W-2 Managing Employee |
Nov 26, 2012 | 50% |
All facility ownership & control disclosures 13
| Facility | Type | Role | Since |
|---|---|---|---|
| Cambridge Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2013 |
| North Las Vegas Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | May 3, 2013 |
| Eastern Family Medical and Dental Center |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 2010 |
| Jackpot Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 1999 |
| Henderson Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 18, 2015 |
| Nevada Health Centers Carson City School Based |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 21, 2015 |
| Nevada Health Centers at Virginia City |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 29, 2015 |
| Nevada Children'S Health Project |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 26, 2018 |
| Nevada Health Centers at Enterprise |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 10, 2019 |
| Mobile Medical Services 1 |
Federally qualified health center | 5% Or Greater Direct Ownership Interest | Dec 29, 2023 |
| Mobile Dental Services 1 |
Federally qualified health center | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 |
| Nellis Family Medical & Dental Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 9, 2024 |
| Pahrump Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 8, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040219000452 | NV | Part B Supplier - Clinic/Group Practice | 7113835307 |
Receives reassigned benefits from 65 practitioners 34 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Virginia City, NV; West Wendover, NV; Amargosa Valley, NV; Austin, NV… |
| O20231011003952 | NV | Part a Provider - Federally Qualified Health Center (FQHC) | 7113835307 | Practice locations: Reno, NV |
National Provider Directory
- Tax ID family
- Nevada Rural Health Cen
- Part of
- Nevada Rural Health Cen
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
790 Willow St
Reno, NV 89502-1304
Mailing address
3325 Research Way
Carson City, NV 89706-7913
Other names
- Willow Street Health Center
Other providers in Reno, NV
- Nevada ENT & Hearing Associates LLC
- Nevada Equine Assisted Therapy - N.E.a.T.
- Nevada Family Practice Residency Program, Inc.
- Nevada Family Practice Residency Program, Inc.
- Nevada Hand Therapy, LLC
- Nevada Heart Institute
- Nevada Heart Institute
- Nevada Histology, Inc.
- Nevada Neurosurgery, LTD Lali Sekhon MD
- Nevada Orthopedic Anesthesia Consultants, LLC
All providers in Reno, NV · Federally Qualified Health Center (FQHC) in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.