NPIMap

Individual provider Active NPI

Nicole Ladnier Killian, PA

  • Physician Assistant
  • Sparks, NV
National Provider Identifier
1982857215
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1135 Issued in NV
Practice address
1525 Los Altos Pkwy
Sparks, NV 89436-6692
Phone
(775) 982-5000
Fax
(775) 982-3900
NPI assigned
Oct 30, 2008
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10557 GA
Physician Assistant 363A00000X PA1135 NV Primary

Addresses

Primary practice location

1525 Los Altos Pkwy
Sparks, NV 89436-6692

Mailing address

1155 Mill St # Msm14
Reno, NV 89502-1576
Phone (775) 982-5262

Other practice location 1

120 Greystone Power Blvd Ste 110
Dallas, GA 30157-8297
Phone (470) 267-1540

Other practice location 2

975 Ryland St Ste 100
Reno, NV 89502-1669
Phone (775) 982-5000

Other identifiers 2

IdentifierTypeStateIssuer
PA1135OtherNVSTATE LICENSE, PHYSICIAN ASSISTANT
12220196OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000694 NV Practitioner - Physician Assistant 2264330083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1525 Los Altos Pkwy
Sparks, NV 89436-6692
Phone (775) 982-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.15 of 100Reported as group
Quality
78.17
Promoting interoperability
100
Improvement activities
40
Cost
75.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10557GAMDPhysician Assistant
PA1135NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Renown Regional Medical Center Past Accepting new patients
Medaisle Express, LLC Past Accepting new patients
Hometown Health Management Company Past Accepting new patients
Washoe Barton Medical Clinic a Nevada Nonprofit Corporation Past Accepting new patients
Provider Network, Inc Past Accepting new patients
Abk Emergency Physicians PLLC Physician Assistant Past Accepting new patients
Renown Urgent Care LLC Physician Assistant Past Accepting new patients
Churchill Mangat Emergency Group PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nkillian49237@direct.renown.org

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1982857215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MSM14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "770-999-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LOS ALTOS PKWY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894366692",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Greystone Power Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301578297",
            "country_code": "US",
            "telephone_number": "470-267-1540",
            "fax_number": "770-999-2792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 Ryland St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021669",
            "country_code": "US",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-5225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "NICOLE",
        "middle_name": "LADNIER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10557",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE, PHYSICIAN ASSISTANT",
            "identifier": "PA1135",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12220196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.