NPIMap

Organization Active NPI

State of Nevada

  • Community/Behavioral Health Agency
  • Reno, NV
National Provider Identifier
1992314264
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STATE OF NEVADA
Practice address
4600 Kietzke Lane BLDG D
Reno, NV 89502
Phone
(775) 688-1481
Fax
(775) 688-1230
NPI assigned
Jul 23, 2020
Organization subpart
Yes
Parent organization
STATE OF NEVADAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Authorized official

Name
Mandi Davis
Title
Deputy Administrator
Phone
(775) 684-7942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4600 Kietzke Lane BLDG D
Reno, NV 89502

Mailing address

2655 Enterprise Dr.
Reno, NV 89512-1666
Phone (775) 688-1600

National Provider Directory

National Provider Directory
Tax ID family
State of Nevada2 organizations share this tax ID, including this one
Part of
State of Nevada

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4600 Kietzke Ln
Bldg D
Reno, NV 89502
Phone (775) 688-1670

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1992314264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 ENTERPRISE DR.",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895121666",
            "telephone_number": "775-688-1600",
            "fax_number": "775-688-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 KIETZKE LANE BLDG D",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89502",
            "telephone_number": "775-688-1481",
            "fax_number": "775-688-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEVADA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEVADA",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MANDI",
        "authorized_official_title_or_position": "DEPUTY ADMINISTRATOR",
        "authorized_official_telephone_number": "775-684-7942"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.