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1281 Terminal Way Ste 110 Reno NV 89502-3246 | |
| (775) 682-0020 | |
| (702) 995-6509 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1281 Terminal Way Ste 110, Reno, Nevada |
| Authorized Official Name and Position | Christopher Carter (OWNER) |
| Authorized Official Contact | 7028303169 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1500 E Tropicana Ave Ste 118 Las Vegas NV 89119-6516 Ph: (775) 682-0020 | 1281 Terminal Way Ste 110 Reno NV 89502-3246 Ph: (775) 682-0020 |
| NPI Number | 1417510439 |
|---|---|
| Provider Enumeration Date | 04/16/2019 |
| Last Update Date | 08/16/2023 |
| Certification Date | 08/16/2023 |
| Medicare PECOS PAC ID | 2961830401 |
|---|---|
| Medicare Enrollment ID | O20200317001445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417510439 | NPI | - | NPPES |
| 1417510439 | Medicaid | NV |
| Provider Name | Anthony L Pollard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295754695 PECOS PAC ID: 6800782012 Enrollment ID: I20121105000164 |
| Provider Name | Nathan Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639602683 PECOS PAC ID: 2860762549 Enrollment ID: I20170728001050 |
| Provider Name | Catherine Karno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144516345 PECOS PAC ID: 0143535245 Enrollment ID: I20171121000356 |
| Provider Name | Mary M Corso-maina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306399167 PECOS PAC ID: 8729498647 Enrollment ID: I20201104002747 |
| Provider Name | Jessica N Reynolds |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1174041735 PECOS PAC ID: 6507104346 Enrollment ID: I20210219000104 |
| Provider Name | Whitney Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447743844 PECOS PAC ID: 3971972316 Enrollment ID: I20221207001963 |
| Provider Name | Aymara Valladares |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184865289 PECOS PAC ID: 1355796244 Enrollment ID: I20240506004613 |
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