PROVIDER NETWORK, INC (NPI# 1508811084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508811084 |
| Entity Type | Organization |
| Organization Name | PROVIDER NETWORK, INC |
| Other Organization Name | FERNLEY MEDICAL GROUP |
| Practice Address |
1343 Newlands Dr W Fernley NV 89408-8926 |
| Mailing Address |
850 Harvard Way Reno NV 89502-2055 |
| Practice Telephone | 7759825000 |
| Practice Fax Number | 7759826504 |
| Mailing Telephone | 7759825262 |
| Mailing Fax Number | 7759825496 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-11-14 |
| Authorized Official Name | DAWN D. AHNER (CFO) |
| Authorized Official Telephone | 7759824404 |
| Is Organization Subpart | Y |
| Parent Organization Name | HOMETOWN HEALTH MANAGEMENT COMPANY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | RR MEDICARE PTAN | CG0436 | 01 |
| Other Name | Type Code |
|---|---|
| Fernley Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659324069 | Provider Network, Inc | Pediatrics | 75 Pringle Way, Suite 300, Reno, NV 89502-1464 | 2006-05-18 |
| Street Address |
1343 NEWLANDS DR W |
| City | FERNLEY |
| State | NV |
| Zip Code | 89408-8926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821043381 | Renown Urgent Care LLC | Internal Medicine | 1343 Newlands Dr W, Fernley, NV 89408-8926 | 2006-05-23 |
| 1851862288 | Community Care Services LLC | Pediatrics | 1343 Newlands Dr W, Fernley, NV 89408-8926 | 2018-12-11 |
| 1952872582 | Community Care Services LLC | Emergency Medicine | 1343 Newlands Dr W, Fernley, NV 89408-8926 | 2018-12-07 |
| 1740679117 | Susan Kitchell | Nurse Practitioner | 1343 Newlands Dr W, Fernley, NV 89408-8926 | 2015-01-22 |
| 1235547514 | Ashley Christine Resavy | Nurse Practitioner | 1343 Newlands Dr W, Fernley, NV 89408-8926 | 2014-07-30 |
| 1568734630 | Cheruba Abraham | Family Medicine | 1343 Newlands Dr W, Fernley, NV 89408 | 2012-02-03 |
| 1700030061 | Jennifer Elizabeth Vogt | Internal Medicine | 1343 Newlands Dr W, Fernley, NV 89408-8926 | 2008-11-12 |
| 1972708923 | Kasie Delaine Reynolds | Nurse Practitioner | 1343 Newlands Dr W, Fernley, NV 89408 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396359634 | Kim Patrick Baumgardner | Pharmacist | 1280 Hwy. 95a North, Fernley, NV 89408 | 2020-09-03 |
| 1891303723 | Amber Timberlake | Marriage & Family Therapist | 415 Highway 95a Suite G701, Fernley, NE 89408 | 2020-07-16 |
| 1609492958 | Ana Alicia Cervantes Tippit | Social Worker | 415 Hwy 95a South Suite D, Fernley, NV 89408 | 2020-06-23 |
| 1437797172 | Whitney Howerton | Peer Specialist | 415 Highway 95a, Suite H802, Fernley, NV 89408 | 2019-12-12 |
| 1689146813 | Golden Years Castle Property Holdings LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 575 Farm District Rd, Fernley, NV 89408 | 2018-12-28 |
| 1508355405 | Raleys | Pharmacy | 1400 State Route 95a N, Fernley, NV 89408 | 2018-05-07 |
| 1528598679 | The Dentists' Office Fernley LLC | Dentist | 300 Highway 95-a South, Ste. 110, Fernley, NV 89408 | 2017-06-12 |
| 1992246474 | Brieauna Nesmith | Counselor | 415 Hwy 95 A, Suite 702 G, Fernley, NV 89408 | 2017-03-16 |
| 1760939359 | Eloisa Martinez | Counselor | 415 Hwy 95 Suite 702g, Fernley, NV 89408 | 2016-09-01 |
| 1033665377 | Lorraine Forbes | Counselor | 415 Highway 95a Building I, Fernley, NV 89408 | 2016-08-28 |
| Find all providers in zip 89408 | ||||
| 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 |
|---|---|---|---|---|
| 1679559439 | Wade E Anderson | Family Medicine | 1260 Nevada Pacific Blvd, Fernley, NV 89408-9871 | 2005-12-22 |
| 1598016636 | Uyen Thuc Le | Family Medicine | 1260 Nevada Pacific Blvd, Fernley, NV 89408-9871 | 2012-09-28 |
| 1568734630 | Cheruba Abraham | Family Medicine | 1343 Newlands Dr W, Fernley, NV 89408 | 2012-02-03 |
| 1447267570 | Cesar P Udani | Family Medicine | 1260 Nevada Pacific Blvd, Fernley, NV 89408-9871 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
| 1992303762 | Chelsey Marie Miller | Family Medicine | 197 Damonte Ranch Pkwy, Reno, NV 89521-1908 | 2020-10-14 |
| 1558968420 | Neuro Health LLC | Family Medicine | 7455 W Washington Ave Ste 140, Las Vegas, NV 89128-4349 | 2020-10-05 |
| 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 |
| 1154934131 | Body & Mind Uplifment LLC | Family Medicine | 2215 Renaissance Dr Ste A, Las Vegas, NV 89119-6723 | 2020-08-28 |
| 1639788599 | Telelab | Family Medicine | 7881 W Charleston Blvd Ste 230, Las Vegas, NV 89117-8327 | 2020-07-27 |
| 1629687926 | Maria Habbi Md | Family Medicine | 501 S Rancho Dr Ste F40, Las Vegas, NV 89106-4834 | 2020-07-23 |
| 1225646805 | Shelley Elizabeth Ameduri | Family Medicine | 3943 Deluge Dr, Las Vegas, NV 89129-6481 | 2020-07-20 |
| 1740807619 | Sherrin Soliman | Family Medicine | 761 Crest Valley Pl, Henderson, NV 89011-2663 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
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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.