TCK Islay, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

TCK ISLAY, INC

Doing business as

Minden Dermatology

Practice address

1661 Lucerne St
Minden, NV 89423-4381

Phone

(775) 782-0700

Fax

(775) 782-0500

NPI assigned

Feb 28, 2020

Last updated

Jul 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Ann Vandiver

Title

Office Manager

Phone

(775) 782-0700

Specialties & licenses 1

Addresses

Other names 1

• MINDEN DERMATOLOGY Doing business as

Practitioners 2

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.

• Shelby E Real, PAC

  • Physician Assistant
  • Carson City, NV
  • NPI 1720557374
  NPD
• Dan E Rowe, M.D.

  • Dermatology Physician
  • Minden, NV
  • NPI 1053314708
  NPD

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1336773373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 LUCERNE ST",
            "city": "MINDEN",
            "state": "NV",
            "postal_code": "894234381",
            "telephone_number": "775-782-0700",
            "fax_number": "775-782-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 LUCERNE ST",
            "city": "MINDEN",
            "state": "NV",
            "postal_code": "894234381",
            "telephone_number": "775-782-0700",
            "fax_number": "775-782-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TCK ISLAY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-28",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "VANDIVER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-782-0700"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINDEN DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MINDEN DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Stiger
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• Carol Tusang Swartz, MD
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• Wendy Vannesa Talavera, LCPC
• Renie Louise Tharp, RD
• Andre Thompson
• Timothy R. Stoll DDS LLC
• Todd a Gray DDS, LTD (Valley Pediatric Dentistry)
• Dominic Torres, QBA

• Dermatology Physician in Minden, NV
• Providers in Minden, NV by specialty
• Dermatology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.