Advanced Gynecology of Reno Poppen

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

ADVANCED GYNECOLOGY OF RENO POPPEN

Practice address

6630 S McCarran Blvd Ste A11
Reno, NV 89509-6145

Phone

(775) 237-2833

Fax

(775) 237-2823

NPI assigned

Jun 28, 2022

Organization subpart

No

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

Authorized official

Name

Kenneth Poppen, DONPI 1730439845

Title

Owner

Phone

(916) 715-1244

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Kenneth Adam Poppen, D.O.

  • Gynecology Physician
  • Reno, NV
  • NPI 1730439845
  Medicare reassignment Care Compare group NPD Authorized official
• Kyla Sweeney, PA-C

  • Physician Assistant
  • Reno, NV
  • NPI 1073280202
  Medicare reassignment Care Compare group
• Laurie A Smith, APRN

  • Women's Health Nurse Practitioner
  • Reno, NV
  • NPI 1780855593
  Medicare reassignment NPD

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1992437057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11742",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895101742",
            "telephone_number": "775-237-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD STE A11",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096145",
            "telephone_number": "775-237-2833",
            "fax_number": "775-237-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GYNECOLOGY OF RENO POPPEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "POPPEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-715-1244",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Reno, NV
• Providers in Reno, NV by specialty
• Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.