| Peavine Family Practice | |
|
2005 Sierra Highlands Dr Ste 101 Reno NV 89523-2301 | |
| (775) 624-6492 | |
| Not Available |
| Full Name | Peavine Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2005 Sierra Highlands Dr Ste 101, Reno, Nevada |
| Authorized Official Name and Position | Ricardo J. Gonzalez (OWNER) |
| Authorized Official Contact | 7756246492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peavine Family Practice 2005 Sierra Highlands Dr Ste 101 Reno NV 89523-2301 Ph: (775) 624-6492 | Peavine Family Practice 2005 Sierra Highlands Dr Ste 101 Reno NV 89523-2301 Ph: (775) 624-6492 |
| NPI Number | 1265958862 |
|---|---|
| Provider Enumeration Date | 08/16/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7416214903 |
|---|---|
| Medicare Enrollment ID | O20171208002287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265958862 | NPI | - | NPPES |
| 13216011297 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10279 (Nevada) | Primary |
| 208D00000X | General Practice | 10279 (Nevada) | Secondary |
| Provider Name | Ricardo J Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326011297 PECOS PAC ID: 1254423791 Enrollment ID: I20070828000906 |
| Provider Name | Lisa M Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265561021 PECOS PAC ID: 0941344055 Enrollment ID: I20100212000312 |
| Provider Name | Leslie Luanne Pace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609004126 PECOS PAC ID: 1850539719 Enrollment ID: I20130604000910 |
Functional Medicine Of Nevada Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6490 S Mccarran Blvd Ste 16, Reno, NV 89509 Phone: 208-385-7711 | |
Neil Road Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3915 Neil Rd, Reno, NV 89502 Phone: 775-870-4333 Fax: 775-870-4633 | |
John R. Lemieux Md Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6630 S. Mccorran Blvd, Building B Suite 16, Reno, NV 89509 Phone: 775-323-5116 Fax: 775-323-7140 | |
Kelly King Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1180 Sharon Way, Reno, NV 89509 Phone: 775-376-1507 | |
Triangle Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1475 Terminal Way, Suite A1, Reno, NV 89502 Phone: 775-331-6400 | |
Dr. Gary Danchak, Omd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9393 Gateway Dr, Reno, NV 89521 Phone: 775-849-9800 Fax: 775-849-9801 | |
Mountain Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9710 S Mccarran Blvd, Reno, NV 89523 Phone: 775-624-6000 Fax: 775-624-6010 |