| Geriatric Specialty Care Of Nevada, Pllc, Steven L. Phillips, M.d. | |
|
6880 S Mccarran Blvd Ste 5 Reno NV 89509-6129 | |
| (775) 398-1981 | |
| (775) 398-1984 |
| Full Name | Geriatric Specialty Care Of Nevada, Pllc, Steven L. Phillips, M.d. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6880 S Mccarran Blvd Ste 5, Reno, Nevada |
| Authorized Official Name and Position | Stephanie Vanzee (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4694018820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Specialty Care Of Nevada, Pllc, Steven L. Phillips, M.d. Po Box 511360 Los Angeles CA 90051-7915 Ph: (775) 398-1981 | Geriatric Specialty Care Of Nevada, Pllc, Steven L. Phillips, M.d. 6880 S Mccarran Blvd Ste 5 Reno NV 89509-6129 Ph: (775) 398-1981 |
| NPI Number | 1205088838 |
|---|---|
| Provider Enumeration Date | 10/14/2008 |
| Last Update Date | 04/01/2025 |
| Medicare PECOS PAC ID | 6901969518 |
|---|---|
| Medicare Enrollment ID | O20090108000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205088838 | NPI | - | NPPES |
| 1205088838 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 9713 (Nevada) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 6596 (Nevada) | Primary |
| Provider Name | Richard Rosen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003813700 PECOS PAC ID: 4688652894 Enrollment ID: I20040727000101 |
| Provider Name | Mayvelyn Y Erichsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053653998 PECOS PAC ID: 5395971790 Enrollment ID: I20131113000599 |
| Provider Name | Probir K Sarker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790126605 PECOS PAC ID: 4587948021 Enrollment ID: I20170301002259 |
| Provider Name | William Richard Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356916597 PECOS PAC ID: 4587065545 Enrollment ID: I20210628002766 |
| Provider Name | Christine Lyzette Villangca Villa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942970462 PECOS PAC ID: 9739579814 Enrollment ID: I20211203000850 |
| Provider Name | Lauren Poppen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306275607 PECOS PAC ID: 1759512916 Enrollment ID: I20220523001222 |
| Provider Name | Sarah Elizabeth Sudtell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396396578 PECOS PAC ID: 5597119016 Enrollment ID: I20231002001833 |
| Provider Name | Jemima Gerardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992550388 PECOS PAC ID: 6204373384 Enrollment ID: I20240807001240 |
| Provider Name | Jessica Currens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427421791 PECOS PAC ID: 7214208180 Enrollment ID: I20240815001089 |
| Provider Name | Randolph Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568456036 PECOS PAC ID: 7517916463 Enrollment ID: I20240820001028 |
| Provider Name | Payam Parvinchiha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851690622 PECOS PAC ID: 5092953760 Enrollment ID: I20240910003793 |
| Provider Name | Erin Kathleen Alicia O'hair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710259361 PECOS PAC ID: 3971802919 Enrollment ID: I20250121000951 |
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