ELIZABETH ANNE JACK (NPI# 1538230545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538230545 |
| Entity Type | Individual |
| Full Name | ELIZABETH ANNE JACK |
| Credential | M.D. |
| Practice Address |
1600 Medical Pkwy Carson City NV 89703-4625 |
| Mailing Address |
Po Box 21609 Carson City NV 89721-1609 |
| Practice Telephone | 7754458502 |
| Practice Fax Number | 7758884448 |
| Mailing Telephone | 7758842455 |
| Mailing Fax Number | 7758840345 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2018-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
5089 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1538230545 | 05 |
| Street Address |
1600 MEDICAL PKWY |
| City | CARSON CITY |
| State | NV |
| Zip Code | 89703-4625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316943913 | Stephen Lane Perry | Internal Medicine | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2005-06-28 |
| 1679194187 | Cheryl Gallio | Dietitian, Registered | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2020-05-06 |
| 1275154171 | Cristina Mosqueda | Registered Nurse | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2020-05-01 |
| 1821619727 | Danielle Dyan Burian | Nurse Practitioner | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2020-05-01 |
| 1538780424 | Valerie R Jakubos | Nurse Practitioner | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2020-05-01 |
| 1548805708 | Chelsea Minifie | Dietitian, Registered | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2019-11-12 |
| 1053955047 | Bethany Adams | Registered Nurse | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2019-11-01 |
| 1104484138 | Hillary Lawson | Dietitian, Registered | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2019-06-04 |
| 1396300042 | Bridget Henderson | Dietitian, Registered | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2019-05-08 |
| 1124598818 | Julie Westwood | Nurse Practitioner | 1600 Medical Pkwy, Carson City, NV 89703-4625 | 2018-11-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487215232 | Madison M Gurries | Audiologist | 1493 Medical Parkway, Carson City, NV 89703 | 2019-06-24 |
| 1609332949 | Tsl Skyline Estates, LLC | Assisted Living Facility | 2705 Mountain St., Carson City, NV 89703 | 2019-02-12 |
| 1790252120 | Reno Orthopaedic Clinic Inc. | Physical Therapist | 1365 Medical Parkway, Carson City, NV 89703 | 2018-10-24 |
| 1265910970 | Marvel Dental Carson City, LLC | Clinic/Center | 410 Fleischmann Way Suite A., Carson City, NV 89703 | 2018-08-03 |
| 1619348489 | Nevada Health Centers Inc. | Clinic/Center | 618 W. Musser Street, Carson City, NV 89703 | 2015-10-19 |
| 1518351089 | Christopher Vlasek | Family Medicine | 412 W John St Ste B, Carson City, NV 89703 | 2015-03-23 |
| 1902215254 | Grant Vaughn Davis | Behavioral Analyst | 1316 Monte Rosa Drive, Carson City, NV 89703 | 2014-08-11 |
| 1437563152 | Nina Patynowski | Nurse Practitioner | 415 W Sofia St, Ste 100, Carson City, NV 89703 | 2014-06-20 |
| 1679853089 | Carson Tahoe Physician Clinics | Family Medicine | 1200 Moutain Street, Suite 220, Carson City, NV 89703 | 2011-08-17 |
| 1790094076 | Darlene Parrish | Occupational Therapy Assistant | 3050 N. Ormsby Bl, Carson City, NV 89703 | 2010-10-04 |
| Find all providers in zip 89703 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518324268 | Umbach Medical Group Pllc | Pathology | 7385 S Pecos Rd Ste 103, Las Vegas, NV 89120-3768 | 2016-01-26 |
| 1093064925 | George Thomas Manilla | Pathology | 1275 Hannah Dr, Elko, NV 89801-2523 | 2012-09-06 |
| 1003173089 | Christy L Perez-valles | Pathology | 343 Elm St Ste 206, Reno, NV 89503-4538 | 2012-04-16 |
| 1063675874 | Allen Robert Anes | Pathology | 20 Anthem Pointe Ct, Henderson, NV 89052-6605 | 2008-07-02 |
| 1366626806 | Adele D. Fung | Pathology | Ms 350, Unr Pathology and Laboratory Dept., Reno, NV 89557 | 2007-12-19 |
| 1669549275 | Roger S Ritzlin | Pathology | 1 Manville Medical Sciences Bldg Mail Stop 350, Department of Pathology and Laboratory Medicine, Reno, NV 89557-0001 | 2006-11-29 |
| 1831277342 | Anton P. Sohn | Pathology | Department of Pathology and Laboratory Medicine, 1 Manville Medical Sciences Bldg/ms 350, Reno, NV 89557-0001 | 2006-11-01 |
| 1235221276 | Sierra Pathology Associates, Inc | Pathology | 475 Kirman Ave, Reno, NV 89502-1907 | 2006-09-28 |
| 1427069863 | Christina A. Samathanam | Pathology | 1664 North Virginia Street, Mail Stop 350, Reno, NV 89557 | 2006-08-10 |
| 1730195322 | Patrick Lee Knight | Pathology | 4230 Burnham Avenue, Las Vegas, NV 89119 | 2006-08-01 |
| Find all providers with the same taxonomy | ||||
| City | CARSON CITY |
| Zip Code | 89703 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.