NPIMap

Organization Active NPI

Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

Doing business as Carson Valley Health Primary Care Minden Village

  • Rural Health Clinic/Center
  • Minden, NV
National Provider Identifier
1265737084
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
3986HOS-8 Issued in NV
Legal business name
WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION
Doing business as
Carson Valley Health Primary Care Minden Village
Practice address
1649 Lucerne St
Suite a & B
Minden, NV 89423-4369
Phone
(775) 782-1603
Fax
(775) 782-3417
NPI assigned
Jan 26, 2011
Last updated
May 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Shannon Rogers
Title
Ceo
Phone
(775) 782-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 3986HOS-8 NV Primary

Addresses

Primary practice location

1649 Lucerne St
Suite a & B
Minden, NV 89423-4369

Mailing address

1520 Virginia Ranch Rd
Gardnerville, NV 89410-5731
Phone (775) 783-3043

Other names 1

  • Carson Valley Health Primary Care Minden Village Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111026000325 NV Part A Provider - Rural Health Clinic 7214835149 Practice locations: Minden, NV

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1265737084. Details of each certification follow.

Rural health clinic certification: CCN 293986

Legal name
WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION
Doing business as
CARSON VALLEY HEALTH PRIMARY CARE MINDEN VILLAGE
Organization structure
CorporationNon-profit
Incorporated
May 31, 1998 in NV
Enrollment address
1649 Lucerne St
Minden, NV 89423-4369

Rural health clinic certification: CCN 293811

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CARSON VALLEY HEALTH PRIMARY CARE MINDEN VILLAGE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 24, 2011
Last certification
Jul 15, 2019
Ownership / control type
2B
Facility address
1649 Lucerne St
Minden, NV 89423

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D0963201Carson Valley Health Primary Care Minden Village1649 Lucerne St, Minden, NV 89423Certificate of waiverJul 25, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gina Zink Individual W-2 Managing Employee Dec 1, 2010
Paul J Fry Individual Corporate DirectorBoard Member Jan 1, 2016
Jeffrey Rahbeck Individual Corporate DirectorBoard Member Jan 26, 2026
Kelly Neiger Individual Corporate DirectorBoard Member Jan 1, 2020
Clinton D Purvance Individual Corporate DirectorBoard Member Apr 2, 2008
Shannon Rogers Individual Corporate OfficerCeo Apr 9, 2026
Corporate DirectorCeo Apr 9, 2026
W-2 Managing Employee Apr 9, 2026

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Paul Fry
    • Orthopaedic Surgery Physician
    • Gardnerville, NV
    • NPI 1255322640

    Corporate Director

    CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carson Valley Health Primary Care Topaz RanchWellington, NV, CCN 293985 Rural health clinic Operational/Managerial Control (100%) Jun 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1265737084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 VIRGINIA RANCH RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105731",
            "telephone_number": "775-783-3043",
            "fax_number": "775-782-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 LUCERNE ST",
            "address_2": "SUITE A & B",
            "city": "MINDEN",
            "state": "NV",
            "postal_code": "894234369",
            "telephone_number": "775-782-1603",
            "fax_number": "775-782-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-782-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NV",
            "license": "3986HOS-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carson Valley Health Primary Care Minden Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minden, NV

Sources for this page

Verify at the official NPI Registry.