FORT MCDERMITT WELLNESS CENTER (NPI# 1801348024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801348024 |
| Entity Type | Organization |
| Organization Name | FORT MCDERMITT WELLNESS CENTER |
| Practice Address |
112 No Reservation Rd Mcdermitt NV 89421-0315 |
| Practice Telephone | 7755328522 |
| Practice Fax Number | 7755328024 |
| Mailing Telephone | 7755328522 |
| Mailing Fax Number | 7755328024 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | VALERIE BARR (CFO) |
| Authorized Official Telephone | 7755328259 |
| Is Organization Subpart | Y |
| Parent Organization Name | FORT MCDERMITT PAIUTE SHOSHONE TRIBE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | APRN002392 | NV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NPI | 1104037704 | 01 |
| CA | NPI | 1053394866 | 01 |
| NV | NPI | 1386917011 | 01 |
| NV | NPI | 1518416577 | 01 |
| NV | NPI | 1043338593 | 01 |
| Street Address |
112 NO RESERVATION RD |
| City | MCDERMITT |
| State | NV |
| Zip Code | 89421-0315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285173773 | Fort Mcdermitt Tribe | Dentist | 112 No Reservation Rd, Mcdermitt, NV 89421-0315 | 2017-02-16 |
| 1407395304 | Fort Mcdermitt Tribe | Dietitian, Registered | 112 No Reservation Rd, Mcdermitt, NV 89421-0315 | 2017-02-13 |
| 1235678137 | Fort Mcdermitt Tribe | Optometrist | 112 No Reservation Rd, Mcdermitt, NV 89421-0315 | 2017-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245627553 | Tracy Marshall | Licensed Practical Nurse | 112 N. Reservation Rd, Mcdermitt, NV 89421 | 2015-04-24 |
| 1043562101 | Brandon Joseph Grow | Emergency Medical Technician, Paramedic | 20 Olavarria, Ft. Mcdermitt E.m.s., Mcdermitt, NV 89421 | 2012-10-12 |
| 1871845958 | David Gerald Cameron | Emergency Medical Technician, Paramedic | 20 Olivarria, Ft. Mcdermitt Ems, Mcdermitt, NV 89421 | 2012-10-12 |
| 1386917011 | Wendy Jewel Dexter | Dietitian, Registered | 112 North Reservation Rd., Mcdermitt, NV 89421 | 2012-02-10 |
| 1285936351 | Usphs, Indian Health Service, Schurz | Ambulance | 20 Olivarria Street, Mcdermitt, NV 89421 | 2010-11-23 |
| 1518416577 | Public Health Service Ihs Mcdermitt Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 112 North Reservation Road, Mcdermitt, NV 89421 | 2016-09-30 |
| 1457610131 | Thelma Rose Simon | Counselor | 112 North Reservation Road, Fort Mcdermitt Indian Health Service, Mcdermitt, NV 89421 | 2012-05-15 |
| 1275820524 | Rodney Dale Burow | Physician Assistant | 112 North Reservation Road, Ihs Ft. Mcdermitt Clinic, Mcdermitt, NV 89421 | 2011-07-07 |
| 1194029322 | Phs Schurz Indian Health Service | Clinic/Center | 112 North Reservation Road, Mcdermitt, NV 89421 | 2011-01-03 |
| 1871634360 | Leora Rose Greenwood | Physician Assistant | 112 North Reservation Road, Mcdermitt, NV 89421-0055 | 2007-02-09 |
| Find all providers in zip 89421 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.