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TAHOE FRACTURE & ORTHOPEDIC MEDICAL CLINIC INC. NPI 1750372140


NPI Information

NPI: 1750372140
Provider Name: TAHOE FRACTURE & ORTHOPEDIC MEDICAL CLINIC, INC.
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 29D2044363

Address:
973 MICA DR
SUITE 201
CARSON CITY, NV
ZIP 89705
Phone: (775) 783-6190
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TAHOE FRACTURE & ORTHOPEDIC MEDICAL CLINIC, INC. is an orthopaedic surgery in Carson City, NV. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. TAHOE FRACTURE & ORTHOPEDIC MEDICAL CLINIC, INC. NPI is 1750372140. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

973 MICA DR
SUITE 201
CARSON CITY, NV
ZIP 89705-255
Phone: (775) 783-6190
Fax: (775) 783-6191

The provider's authorized official is Jeffrey Cummings .
The authorized official title is Physician/partner and has the following contact phone number (775) 783-6190.

The CLIA number assigned to this NPI record is 29D2044363 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 10/12/2011.


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
1207XS0106XOrthopaedic SurgeryHand SurgeryNo
2207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the SpineNo
3363L00000XNurse PractitionerNo
4363A00000XPhysician AssistantNo
5213ES0103XPodiatristFoot & Ankle Surgery1006NEVADANo
6207X00000XOrthopaedic SurgeryYes

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
1CC4631OTHERNEVADABCBS
20478150007MEDICARE NSCNEVADA
30478150001MEDICARE NSCCALIFORNIA
4VWQBCTMEDICARE PINNEVADA
5C03071OTHERCALIFORNIARAILROAD
6CH0545OTHERNEVADARAILROAD
7ZZZ49317ZMEDICARE PINCALIFORNIA
8100506168MEDICAIDNEVADA
9ZZZ49317ZOTHERCALIFORNIAMEDI-CAL
100478150008MEDICARE NSCNEVADA
110478150004MEDICARE NSCNEVADA

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: 4/28/2024

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