Healthcare Provider Details

I. General information

NPI: 1093190415
Provider Name (Legal Business Name): ROSS M JENSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

973 MICA DR STE 200
CARSON CITY NV
89705-7258
US

IV. Provider business mailing address

973 MICA DR STE 200
CARSON CITY NV
89705-7258
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-7225
  • Fax: 775-461-3089
Mailing address:
  • Phone: 775-445-7225
  • Fax: 775-461-3089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberR3810
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number20191
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: