Healthcare Provider Details

I. General information

NPI: 1962963728
Provider Name (Legal Business Name): VISIONARY SURGERY CENTER OF NEVADA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10463 DOUBLE R BLVD
RENO NV
89521-5866
US

IV. Provider business mailing address

10463 DOUBLE R BLVD STE 200
RENO NV
89521-8922
US

V. Phone/Fax

Practice location:
  • Phone: 775-562-2121
  • Fax: 775-322-1050
Mailing address:
  • Phone: 775-562-2121
  • Fax: 775-322-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALLISON H WHITLOW
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 775-799-2200