Healthcare Provider Details

I. General information

NPI: 1669460002
Provider Name (Legal Business Name): CARSON ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 VISTA LANE
CARSON CITY NV
89703-4643
US

IV. Provider business mailing address

1385 VISTA LN
CARSON CITY NV
89703-4643
US

V. Phone/Fax

Practice location:
  • Phone: 775-884-4567
  • Fax: 775-884-4569
Mailing address:
  • Phone: 775-884-4567
  • Fax: 775-884-4569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number37791
License Number StateNV

VIII. Authorized Official

Name: DR. JASON COLLINS
Title or Position: DIRECTOR
Credential: MD
Phone: 775-329-4600