PRIDE MEDICAL SPA AND WELLNESS CENTER INC (NPI# 1861036063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861036063 |
| Entity Type | Organization |
| Organization Name | PRIDE MEDICAL SPA AND WELLNESS CENTER INC |
| Other Organization Name | RADIANCE KETAMINE CLINIC |
| Practice Address |
5365 Mae Anne Ave Ste A10 Reno NV 89523-1841 |
| Practice Telephone | 7754321500 |
| Practice Fax Number | 7754321002 |
| Mailing Telephone | 7754321500 |
| Mailing Fax Number | 7754321002 |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-12-17 |
| Authorized Official Name | MR. GREGORY JONES (CLINIC DIRECTOR) |
| Authorized Official Telephone | 7752170377 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Radiance Ketamine Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543968 | Pride Medical Spa and Wellness Center Inc | Psychiatry & Neurology | 5365 Mae Anne Ave Ste A10, Reno, NV 89523-1841 | 2019-11-25 |
| Street Address |
5365 MAE ANNE AVE STE A10 |
| City | RENO |
| State | NV |
| Zip Code | 89523-1841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861765042 | Going Places | Community Based Residential Treatment Facility, Mental Illness | 5365 Mae Anne Ave Ste A10, Reno, NV 89523-1841 | 2012-02-17 |
| 1912543968 | Pride Medical Spa and Wellness Center Inc | Psychiatry & Neurology | 5365 Mae Anne Ave Ste A10, Reno, NV 89523-1841 | 2019-11-25 |
| 1639623820 | Going Places | Respite Care | 5365 Mae Anne Ave Ste A10, Reno, NV 89523-1841 | 2016-08-05 |
| 1891043832 | Francisco L Dofeliz | Family Medicine | 5365 Mae Anne Ave Ste A10, Reno, NV 89523-1841 | 2012-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992351316 | Brian K. Iriye Md and Associates Ltd. | Obstetrics & Gynecology | 9780 S. Mccarran Blvd, #1, Reno, NV 89523 | 2019-08-12 |
| 1003323510 | Tate Health and Wellness, Pllc | Nurse Practitioner | 2005 Sierra Highlands Dr., Suite 101, Reno, NV 89523 | 2018-01-05 |
| 1952810194 | Michael Anacker | Occupational Therapist | 5410 Simons Drive, Reno, NV 89523 | 2017-09-20 |
| 1033570981 | Alison Butler | Speech-Language Pathologist | 7289 Heatherwood Dr., Reno, NV 89523 | 2016-03-18 |
| 1033586417 | Phoenix Providers | Preferred Provider Organization | 3844 Joy Ln, Reno, NV 89523 | 2015-09-01 |
| 1841637006 | Nicole Katherine Butler | Audiologist | 9770 S. Mccarren Blvd, Reno, NV 89523 | 2013-05-29 |
| 1477803922 | Laura Soukup | Speech-Language Pathologist | 5820 Lindsay Drive, Reno, NV 89523 | 2012-09-12 |
| 1578812939 | Jeanine Kay Johnson | Community Health Worker | 9195 Bay Meadows Dr., Reno, NV 89523 | 2012-08-31 |
| 1851626931 | Steven Koning | Optometrist | 9700 South Mccarran Blvd., Reno, NV 89523 | 2009-10-07 |
| 1306083712 | Medical Physics Services | General Acute Care Hospital | 2027 Thornbury Ct., Reno, NV 89523 | 2009-01-08 |
| Find all providers in zip 89523 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303762 | Chelsey Marie Miller | Family Medicine | 197 Damonte Ranch Pkwy, Reno, NV 89521-1908 | 2020-10-14 |
| 1568079804 | Natalie Irene Bernard | Family Medicine | 7610 Tamra Dr, Reno, NV 89506-6731 | 2020-09-30 |
| 1669089983 | Helena Class-alexander Arpn LLC | Family Medicine | 1905 California Ave, Reno, NV 89509-2369 | 2020-09-30 |
| 1427609247 | Lindsey A Butcher | Family Medicine | 1905 Horse Prairie Rd, Reno, NV 89521-4361 | 2019-09-23 |
| 1821641937 | Alm Family Practice | Family Medicine | 1895 Plumas St Ste 6, Reno, NV 89509-3384 | 2019-07-17 |
| 1790236180 | Medtrans Reno Casal, Pllc | Family Medicine | 890 Mill St Fl 4, Reno, NV 89502 | 2016-10-20 |
| 1003266032 | Matthew Gordon | Family Medicine | 10539 Professional Cir Ste 200, Reno, NV 89521 | 2016-06-21 |
| 1760843668 | Karen Thiele | Family Medicine | Brigham Bldg 316unsom, Reno, NV 89557-0169 | 2016-03-19 |
| 1538586417 | Katelyn Bruner | Family Medicine | Renown Medical Group Caughlin, 4796 Caughlin Pkwy #108, Reno, NV 89519-0907 | 2014-03-28 |
| 1023372349 | Alejandro De La Parra Landa | Family Medicine | 1664 N Virginia Street Ms 316 Brigham Bldg, Reno, NV 89557-0001 | 2012-07-02 |
| Find all providers in RENO | ||||
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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.