Healthcare Provider Details

I. General information

NPI: 1528649100
Provider Name (Legal Business Name): MATTHEW GREGORY ERNY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 N ARLINGTON AVE STE 670
RENO NV
89503-4453
US

IV. Provider business mailing address

4838 SPARKS BLVD STE 102
SPARKS NV
89436-8156
US

V. Phone/Fax

Practice location:
  • Phone: 775-870-1480
  • Fax: 775-870-1630
Mailing address:
  • Phone: 775-870-1480
  • Fax: 775-870-1630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberDO4107
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberDO4107
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: