Healthcare Provider Details

I. General information

NPI: 1699654061
Provider Name (Legal Business Name): RYAN THOMPSON RRA, RT(R)(CT)(ARRT)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL PKWY
CARSON CITY NV
89703-4625
US

IV. Provider business mailing address

2464 ROSEMARY DR
SPARKS NV
89434-2543
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-8000
  • Fax:
Mailing address:
  • Phone: 651-788-2334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License NumberPL03791
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License NumberPL03791
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License NumberPL03791
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: