Active NPI
Carson-Tahoe Pathology DRS Jack & Doberneck LTD
- Clinical Medical Laboratory
- Carson City, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 5089
- Legal business name
- CARSON-TAHOE PATHOLOGY DRS JACK & DOBERNECK LTD
- Practice address
- 1600 Medical Pkwy
Carson City, NV 89703-4625 - Phone
- (805) 250-5764
- Fax
- (775) 888-4448
- NPI assigned
- Jan 23, 2007
- Last updated
- Jan 19, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Elizabeth Jack, M.D.
- Title
- Partner
- Phone
- (775) 445-8502
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 5089 | NV | Primary |
Addresses
Primary practice location
1600 Medical Pkwy
Carson City, NV 89703-4625
Mailing address
1633 Erringer Rd Ste 101
Simi Valley, CA 93065-3580
Phone (805) 250-5764
Other names 1
- DBA Carson-Tahoe Pathology, LTD
National Provider Directory
National Provider DirectoryLocations
1633 Erringer Rd
Ste 101
Simi Valley, CA 93065
775 Fleischmann Way
#2051
Carson City, NV 89703
Phone (702) 885-4327
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Anatomic Pathology & Clinical Pathology Physician
- Carson City, NV
- NPI 1538230545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674086400000",
"number": "1104971183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 ERRINGER RD STE 101",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930653580",
"telephone_number": "805-250-5764",
"fax_number": "805-578-3911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 MEDICAL PKWY",
"city": "CARSON CITY",
"state": "NV",
"postal_code": "897034625",
"telephone_number": "805-250-5764",
"fax_number": "775-888-4448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARSON-TAHOE PATHOLOGY DRS JACK & DOBERNECK LTD",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-23",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A",
"authorized_official_last_name": "JACK",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "775-445-8502",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NV",
"license": "5089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "DBA Carson-Tahoe Pathology, LTD",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Carson City, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.