CLEMMENSEN, ADAMS, & TACK PSC (NPI# 1780852368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780852368 |
Entity Type | Organization |
Organization Name | CLEMMENSEN, ADAMS, & TACK PSC |
Other Organization Name | CARSON DERMATOLOGY |
Practice Address |
1100 S Carson St Carson City NV 89701-5232 |
Practice Telephone | 7758837811 |
Practice Fax Number | 7758837871 |
Mailing Telephone | 7758837811 |
Mailing Fax Number | 7758837871 |
Enumeration Date | 2008-02-15 |
Last Update Date | 2015-01-22 |
Authorized Official Name | DR. DAVID ALAN TACK (PRESIDENT) |
Authorized Official Telephone | 7758837811 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Carson Dermatology | Doing Business As Name - Organization |
Street Address |
1100 S CARSON ST |
City | CARSON CITY |
State | NV |
Zip Code | 89701-5232 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871551747 | Charles Clemmensen | Dermatology | 1100 S Carson St, Carson City, NV 89701-5232 | 2006-05-02 |
1124032990 | David Alan Tack | Dermatology | 1100 S Carson St, Carson City, NV 89701-5232 | 2006-07-28 |
1841214632 | Ruth Elizabeth Adams | Dermatology | 1100 S Carson St, Carson Dematology, Carson City, NV 89701-5232 | 2006-07-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295398741 | Tammy Lea Ritter | Registered Nurse | 727 Fairview Dr, Suite A, Carson City, NV 89701 | 2019-04-19 |
1417445644 | Veatrice Marie Buckley | Chore Provider | 343 Fairview Dr., #101, Carson City, NV 89701 | 2018-04-24 |
1619417821 | Melhuish & Associates PC | Durable Medical Equipment & Medical Supplies | 2350 S Carson St, Ste 3, Carson City, NV 89701 | 2017-03-07 |
1942625579 | Kristi Lin Berg | Social Worker | 777 E William St Ste 102, Carson City, NV 89701 | 2014-02-18 |
1992141493 | Rumi Ota | Marriage & Family Therapist | 755 N Roop St Ste 101, Carson City, NV 89701 | 2013-05-11 |
1700127743 | Pauline Jenni King | Nurse Practitioner | 1206 S Carson St, Carson City, NV 89701 | 2013-03-14 |
1740524503 | Bodie Ward Coates | Counselor | 755 N. Roop St. #101, Carson City, NV 89701 | 2012-11-19 |
1699085407 | Jacque Michael Negrete | Social Worker | 777 E William St Ste 106, Carson City, NV 89701 | 2010-10-14 |
1295045102 | Mountain West Anesthesia | Nurse Anesthetist, Certified Registered | 1801 North Carson Street, Carson City, NV 89701 | 2010-10-13 |
1831342617 | Heal Therapy of Nevada | Social Worker | 405 N Roop St, Carson City, NV 89701 | 2008-10-24 |
Find all providers in zip 89701 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871551747 | Charles Clemmensen | Dermatology | 1100 S Carson St, Carson City, NV 89701-5232 | 2006-05-02 |
1124032990 | David Alan Tack | Dermatology | 1100 S Carson St, Carson City, NV 89701-5232 | 2006-07-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336773373 | Tck Islay, Inc | Dermatology | 1624 10th St Ste 1, Minden, NV 89423-4477 | 2020-02-28 |
1538708573 | Skin Docs | Dermatology | 410 S Rancho Dr, Las Vegas, NV 89106-4802 | 2019-12-21 |
1609358886 | Jdr Dermatology Research, LLC. | Dermatology | 9080 W Post Rd Ste 100, Las Vegas, NV 89148 | 2018-09-04 |
1003310368 | Lenore S Kakita Md LLC | Dermatology | 9360 W Flamingo Rd Ste 110-325, Las Vegas, NV 89147-6410 | 2018-03-21 |
1619492378 | Fife Dermatology, PC 1 | Dermatology | 10080 West Alta Drive, Suite 120, Las Vegas, NV 89145-8651 | 2017-08-03 |
1194268987 | J H Daulat Do PC | Dermatology | 1875 S Nellis Blvd, Las Vegas, NV 89104-6215 | 2016-11-28 |
1396192761 | Craig Parson | Dermatology | 6850 N Durango Dr Ste 100, Las Vegas, NV 89149-4596 | 2016-05-16 |
1912349408 | Cyril M. Joseph | Dermatology | 1470 E Calvada Blvd Ste 600, Pahrump, NV 89048-3906 | 2013-07-24 |
1942565205 | Centennial Dermatology and Skin Cancer Inc | Dermatology | 5500 Painted Mirage Road, Suite 100, Las Vegas, NV 89149 | 2012-07-11 |
1649543463 | Aaron William Mccook | Dermatology | 340 Falcon Ridge Pkwy Ste 202, Mesquite, NV 89027-8851 | 2012-02-10 |
Find all providers with the same taxonomy |
City | CARSON CITY |
Zip Code | 89701 |
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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.