CARSON TAHOE REGIONAL HEALTHCARE NPI 1447800818

Clinic/Center (Ambulatory Surgical) in Carson City, NV

Organization Clinic/Center Ambulatory Surgical

About CARSON TAHOE REGIONAL HEALTHCARE

Carson Tahoe Regional Healthcare is a provider established in Carson City, Nevada specializing in clinic/center. The NPI number of Carson Tahoe Regional Healthcare is 1447800818 and was assigned on September 2019. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated September 2019. The authorized official of this NPI record is Mitchell Watson (Chief Financial Officer)

NPI

1447800818

Provider NameCARSON TAHOE REGIONAL HEALTHCARE
Provider Location Address973 MICA DR STE 102 CARSON CITY, NV 89705
Provider Mailing AddressPO BOX 2168 1600 MEDICAL PARKWAY CARSON CITY, NV 89702
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date09-17-2019
Last Update Date09-17-2019

Primary Taxonomy

Taxonomy Code261QA1903X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAmbulatory Surgical

Business Address

CARSON TAHOE REGIONAL HEALTHCARE
973 MICA DR STE 102
CARSON CITY, NV
ZIP 89705
Phone: (775) 445-7970

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Mailing Address

CARSON TAHOE REGIONAL HEALTHCARE
PO BOX 2168
1600 MEDICAL PARKWAY
CARSON CITY, NV
ZIP 89702
Phone: (775) 445-8672

Authorized Official

Authorized Official Name MITCHELL WATSON
Authorized Official TitleCHIEF FINANCIAL OFFICER
Authorized Official Phone(775) 445-8672

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
001013843MEDICAID (05)NV
001113843MEDICAID (05)NV
001213843MEDICAID (05)NV

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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