Provider Type Icon

FT. MCDERMITT PAIUTE SHOSHONE TRIBE NPI 1316449291


NPI Information

NPI: 1316449291
Provider Name: FT. MCDERMITT PAIUTE SHOSHONE TRIBE

Doing Business As: FT. MCDERMITT WELLNESS CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
112 NORTH RESERVATION RD
MCDERMITT, NV
ZIP 89421
Phone: (775) 532-8522
Get Directions

FT. MCDERMITT PAIUTE SHOSHONE TRIBE is a federally qualified health center (fqhc) clinic center in Mcdermitt, NV. FT. MCDERMITT PAIUTE SHOSHONE TRIBE NPI is 1316449291. The provider is registered as an organization entity type.
The provider Is Doing Business As Ft. Mcdermitt Wellness Center.

The provider's business location address is:

112 NORTH RESERVATION RD
MCDERMITT, NV
ZIP 89421-315
Phone: (775) 532-8522
Fax: (775) 532-8024

The provider's authorized official is Fergus John Laughridge .
The authorized official title is Health Director and has the following contact phone number (775) 532-8522.

The enumeration date for this NPI number is 3/6/2018 and was last updated on 3/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11588710719MEDICAIDCALIFORNIA
2100561450MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.