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File Work Comp Injuries Online at: https://www.benchmarkadministrators.com/state/nevada.html 1. Scroll Down to Required State Forms and select Nevada – C3 2. Decide if you would like a copy of the completed form emailed to you. 3. Enter Employer Information, then hit next. 4. Enter Employee Information, then hit next. 5. Enter Accident/Disease Information, then hit next. 6. Enter Injury/Disease Information, then hit next. 7. Enter Lost Time Information, then hit next. 8. Submit the Information. *If you are missing information, you can just hit next and continue with the next page of information* Please send the Form C3 and the medical slip to: Benchmark Administrators 7881 W. Charleston Blvd., Suite 210 Las Vegas, NV 89117 Telephone (702) 873-5115 Toll free (800) 362- 5198 Fax (702) 876-5584 24-HOUR CLAIM REPORTING HOTLINE: 1-866-337-0891 Customer Service Representatives are on staff 24 hours per day to assist you with reporting a claim. Please have the injured worker’s information available as well as the accident description.

Please send the Form C3 and the medical slip to

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Page 1: Please send the Form C3 and the medical slip to

 

File Work Comp Injuries Online at: https://www.benchmarkadministrators.com/state/nevada.html 

1. Scroll Down to Required State Forms and select Nevada – C3 2. Decide if you would like a copy of the completed form e‐mailed to you. 3. Enter Employer Information, then hit next. 4. Enter Employee Information, then hit next. 5. Enter Accident/Disease Information, then hit next. 6. Enter Injury/Disease Information, then hit next. 7. Enter Lost Time Information, then hit next. 8. Submit the Information. 

 *If you are missing information, you can just hit next and continue with the next page of information* 

Please send the Form C3 and the medical slip to:

Benchmark Administrators 7881 W. Charleston Blvd., Suite 210 Las Vegas, NV 89117 Telephone (702) 873-5115 Toll free (800) 362- 5198 Fax (702) 876-5584

24-HOUR CLAIM REPORTING HOTLINE: 1-866-337-0891 Customer Service Representatives are on staff 24 hours per day to assist you with reporting a claim. Please have the injured worker’s information available as well as the accident description.

 

 

Page 2: Please send the Form C3 and the medical slip to

Injured worker must sign and return to employer’s

office . Employer must return to Benchmark Administrators, LLC.

___________________

EMPLOYEE SIGNATURE

FIRMA DEL EMPLEADO

___________________ SUPERVISOR SIGNATURE

FIRMA DEL SUPERVISOR

_____ DATE

FECHA

Benchmark Administrators, LLC7881 W. Charleston Blvd.

Suite 210Las Vegas, NV 89117

Tel (702) 873-5115 Toll Free (800) 362-5198

Fax (702) 876-5584

Page 3: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office. Employer returns to Benchmark Administrators, LLC.

Injured Worker’s Name: ___________________________________________________________________________________

Nombre del Trabajador Lesionado:

Claim Number: __________________________ Social Security #: _______________________

Numero de Reclam Numero de Seguro Social:

Injury Date: _________________ Employer: ______________________________________

Fecha de Accidente: Nombre de la Compania/Empresa:

Employer’s Address: ______________________________________________________________________________________

Direccion de la Compania/Empresa:

Please provide the information requested below, sign and date the form, and return it to your insurer. Your signature on this form

also acts as a release to acquire information affecting your claim from other entities. Failure to complete and return this form to

your claims administrator in a timely manner could affect your benefits or delay the resolution of your claim.

PLEASE CHECK THE APPROPRIATE BOX BELOW AND PROVIDE THE INFORMATION REQUESTED

I have no prior conditions, injuries, or disabilities, of which I am aware, that might affect the disposition of the claim

referenced above. If you checked this box, no further information is needed at this point. Yo no tengo ningunas

condiciones, lesiones, o desabilidades anteriores, de cual yo tenga conocimiento, que puedan affectar la disposicion

de el reclamo mencionado arriba. Si usted marca esta caja, ninguna informacion adicional es necesaria en este

momento.

I have a prior condition, injury, or disability that could affect the disposition of the claim referenced above (this can

include birth defects, prior surgeries, injuries, etc., whether work related or not). If you checked this box, indicating a

pre-existing condition, please explain in detail in the space below. You are encouraged to attach additional sheets of

paper to this form if necessary to fully explain the condition. Yo tengo una condicion,lesion, o disabilidad anterior la

cual pueda affectar mi reclamo mencionado arriba (esto puede incluir defectos de nacimiento, cirugias/operaciones

anteriores, lesiones, etc., aunque sea o no relacionado al trabajo). Si usted marca

________________________________________________________________________________________________________

________________________________________________________________________________________________________

REQUEST FOR ADDITIONAL MEDICAL INFORMATION AND RELEASE FORM

PETICION PARA INFORMACION MEDICA Y FORMA DE DESCARGO

I, the undersigned injured worker, or legal representative of the injured worker named above, do

hereby certify that the information provided below is complete, true and correct to the best of my

knowledge and that I have provided that information in order to obtain the benefits provided for

by all applicable codes and rules as adopted by the State. I hereby authorize any physician,

chiropractor, practitioner, or other person, any hospital, including Veteran’s Administration or

other governmental hospital, any medical service organization, any insurance company, or other

entity or organization, governmental or private, to release to each other any medical or other

information acquired, including benefits paid or payable, concerning this or any other disabilities

or injuries. A photocopy of this authorization shall be as valid as the original.

Signature Date

Firma Fecha

PRIOR HISTORY INFORMATION

Benchmark Administrators, LLC7881 W. Charleston Blvd.

Suite 210Las Vegas, NV 89117

Telephone (702) 873-5115Toll free (800) 362- 5198

Fax (702) 876-5584

Page 4: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office. Employer returns to Benchmark Administrators, LLC.

Injured Worker Accident Statement Page 1 of 2

COMPANY NAME: ______________________________________________________________________

Nombre de la Compania/Empresa:

Injured Worker: _________________________________________________________________________________________

Nombre Del Trabajador Lesionado:

Social Security #: ______________________ Accident Date: _______________________

Numero de Seguro Social: Fecha de Accidente:

Job Title: ______________________________________________________________________________________________

Ocupacion:

Home Address: _________________________________________________________________________________________

Direccion:

Home Phone: __________________ Age: ______ Sex: ____Male ____Female

Numero de Telefono: Edad: Sexo: Hombre Mujer

To who was the injury/illness reported? _____________________________________________________________________

A quien le reporto su accidente?

When was the injury/illness reported? Date: _____/_____/_____ Time: ______________

Cuando reporto su accidente? Fecha: Hora:

Where did the accident occur? ______________________________________________________________________________

En donde occurio el accidente?

LOCATION OF ACCIDENT/UBICACION DEL ACCIDENTE _______________________________________________

Job site – Facility/Sitio De Trabajo : _______________________________________________

Name & Address/Nombre y Direccion _______________________________________________

Local Supervisor to whom you report: _______________________________________________________________________

Supervisor Local al cual usted se reporta?

Were there any witnesses? ____Yes ____No IF YES, who? ___________________________________________________

Hubo algun testigo? Si No Si asi fue, quien?

What were you doing at the time of the accident? (Please describe events leading to injury/ illness. Name any object or substance

involved and how it was involved.)

Que estaba haciendo cuando sucedio el accidente? (Por favor describa que propicio el accidente. Mencione cualquier objecto o

substancia involucrada en el accidente y de que manera fue involucrada.)

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Were you hurt? Yes/Si No Fue usted lesionado?

INJURED WORKER ACCIDENT STATEMENT

DECLARACION DEL ACCIDENTE DEL EMPLEADO

OVER

Benchmark Administrators, LLC7881 W. Charleston Blvd.

Suite 210Las Vegas, NV 89117

Tel (702) 873-5115Toll Free (800) 362-5198

Fax (702) 876-5584

Page 5: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office.Employer returns to Benchmark Administrators, LLC.

Injured Worker Accident Statement Page 2 of 2

Continued How did the accident occur? Please be specific. Name machine, tool, vehicle, substance, etc. in use at time of accident:

Como sucedio el accidente? Por favor especifique. Mencione maquinaria, herramienta, vehiculo, substancia, etc. en uso en el

momento del accidente:____________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Describe injury/illness:

Describa lesion o enfermedad:_______________________________________________________________________________

________________________________________________________________________________________________________

Did you seek medical attention? Yes/Si No

Recibio atencion medical?

If “YES,” when did you seek medical attention?

Si asi fue, cuando recibio atencion medica?____________________________________________________________________

Physician’s name and address:

Nombre y direccion del medico que lo atendio?_________________________________________________________________

_______________________________________________________________________________________________________

How can you avoid and accident in the future?

Como puede usted evitar un accidente en el futuro?______________________________________________________________

_______________________________________________________________________________________________________

How can the company help to avoid this type of accident?

Como puede la compania ayudar a evitar este tipo de accidente?___________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

I understand that falsification of this statement, or any misrepresented information contained in this statement, can result in

disciplinary action. Entiendo que falsificacion de esta declaracion o dar cualquier informacion erronea en esta declaracion

puede resultar en accion disciplinaria.

____________________________________ __________________

Signature/Firma Date/Fecha

INJURED WORKER ACCIDENT STATEMENT

DECLARACION DEL ACCIDENTE DEL EMPLEADO

Page 6: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office.

Employer returns to Benchmark Administrators, LLC.

Injured Worker Accident Statement Page 1 of 3

This form must be completed in it’s entirety by the IMMEDIATE SUPERVISOR of the injured employee and must accompany

all Employer’s First Report of Injury or Illness forms (form 122)

Este formulario debera ser llenado completamente poe el supervisor inmediato del empleado lesionado y debe de acompanar el

Primer Reporte de Lesion o Enfermedad (Formulario 122)

Injured Worker’s Name: ___________________________________________________________________________________

Nombre del Empleado Lesionado:

Job Site/Injury Location: ___________________________________________________________________________________

Lugar de Trabajo/Ubicacion de Accidente:

Date of injury/illness: _____/_____/_____ Time of injury/illness occurred: ________________________________________

Fecha de Accidente: Hora en que sucedio lesion o enfermedad:

Time Employee’s Shift Begins: ______________________ a.m. / p.m.

Hora en la cual el trabajador lesionado empieza su turno:

Employee’s hire date: _____/_____/_____

Fecha que el empleado lesionado fue contradado:

Home Phone: __________________ Age: ______ Sex: ____Male ____Female

Numero de Telefono: Edad: Sexo: Hombre Mujer

Who reported the injury/illness? _____________________________________________________________________________

Quien reporto el accidente?

When was injury/illness reported? ____________________________________________________________________________

Cuando fue reportado el accidente?

To whom was it reported? __________________________________________________________________________________

A quien fue reportado?

Type of injury/illness:

Tipo de lesion o enfermedad: ________________________________________________________________________________

________________________________________________________________________________________________________

What was the Employee doing when the injury/illness occurred?

Que hacia el empleado cuando sucedio la lesion o enfermedad?____________________________________________________

_______________________________________________________________________________________________________

Describe how the injury/illness occurred:

Describa como sucedio la lesion o enfermedad: _________________________________________________________________

________________________________________________________________________________________________________

SUPERVISOR’S REPORT OF INVESTIGATION

REPORTE DE INVESTIGACION DEL SUPERVISOR

Benchmark Administrators, LLC7881 W. Charleston Blvd.

Suite 210Las Vegas, NV 89117

Tel (702) 873-5115Toll Free (800) 362-5198

Fax (702) 876-5584

OVER

Page 7: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office.

Employer returns to Benchmark Administrators, LLC.

Injured Worker Accident Statement Page 2 of 3

Continued

Were there any witnesses? Yes/Si No

Hubo algun Testigo?

Could this injury/illness have been prevented? Yes/Si No

Se hubiera podido prevenir esta lesion o enfermedad?

If “YES,” how?

Si contesto Si, explique:___________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

Specifically, what did anyone do, or fail to do, that caused the accident?

Especifique claramente que hicieron o dejaron de hacer las demas personas para que este accidente ocurriera?______________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

Was this injury/illness the result of unsafe working condition(s) at the job site?

Fue esta lesion o enfermedad el resultado de una situacion insegura en el lugar del trabajo?

Yes/Si No

If “YES,” please describe the condition(s):

Si contesto SI, Por favor describa la situacion: _________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

What action(s) have been taken to prevent such an injury/illness from occurring again?

Que acciones se han tomado para prevenir que no sucedan este tipo de accidentes?

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

SUPERVISOR’S REPORT OF INVESTIGATION

REPORTE DE INVESTIGACION DEL SUPERVISOR

If “YES,” see attached Witness Statement sheet

Si hubo, vea la Declaracion del Testigo

Page 8: Please send the Form C3 and the medical slip to

Injured Worker Accident Statement Page 3 of 3

Continued Have you any reason to believe this was not an on-the-job injury/illness?

Cree Usted que haya alguna razon de que lesion o enfermedad no ocurrio en las hora de trabajo?

Yes/Si No Unknown

If “YES,” please supply as much information and detail as possible:

Si asi fue, proporcione la mayor informacion posible detalladamente: _______________________________________________

_______________________________________________________________________________________________________

Is the employee alleging a Worker’s Compensation claim? Yes/Si No

Esta el empleado exigiendo un reclamo de Compensacion Laboral?

Has the employee missed any time from work? Yes/Si No

Ha perdido el empleado dias de trabajo a razon del accidente?

What was the next regularly scheduled shift missed as a result of the injury/illness?

Cual fue el horario de trabajo regular perdido a consequencia de este accidente?_____________________________________

List the dates of complete shifts the employee missed, but would have normally worked if not injured:

Explique la fecha de los horarios completos que el empleado perdio, los cuales hubiera trabajado de no haberse lesionado?

____/____/____ ____/____/____ ____/____/____ ____/____/____ ____/____/____

List the schedule regularly worked by the employee. If no set schedule, show number of days usually worked by the employee

during average week: Explique el horario regular del empleado lesionado. Si el empleado lesionado no tiene un horario fijo,

muestre el numero de dias que el empleado lesionado trabaja usualmente en un periodo de una semana:.

_____________/_____________/______________/______________/______________/______________/______________/

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Domingo Lunes Martes Miercoles Jueves Viernes Sabado

Has the employee returned to work? Yes/Si No

Ha regresado a trabajar el empleado lesionado?

Date Returned: ____/____/____ Expected Date of Return: ____/____/____

Fecha que regreso: Fecha que regresara:

I understand that falsification of this statement, or any misrepresented information contained in this statement, can result in disciplinary action.

Entiendo que falsificacion de esta declaracion o dar cualquier informacion erronea en esta declaracion puede resultar en accion disciplinaria.

____________________________________ ____________________

Signature /Firma Date/Fecha

Injured worker must sign & return to employer’s office. Employer returns to Benchmark Administrators, LLC.

SUPERVISOR’S REPORT OF INVESTIGATION

REPORTE DE INVESTIGACION DEL SUPERVISOR

If “YES,” please complete the following questions:

Si Contesto “SI” por favor complete las siguientes preguntas

Page 9: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office. Employer returns to Benchmark Administrators, LLC.

Injured Worker Accident Statement Page 1 of 2

Accident Date: _____/_____/_____ Location of Accident: _____________________________

Fecha del Accidente: Lugar del Accidente:

Injured Worker’s Name: ___________________________________________________________________________________

Nombre del Empleado Lesionado:

Witness Name: ___________________________________________________________________________________________

Nombre del Testigo:

Witness Home Address: ___________________________________________________________________________________

Direccion del Testigo:

Witness Home Phone: ______________________ Age: ________ Sex: ______Male ______Female

Numero de Telefono del Testigo: Edad: Sexo: Hombre Mujer

Witness Job Title: ________________________________________________________________________________________

Ocupacion del Testigo:

Where did the accident occur? _______________________________________________________________________________

Donde ocurrio el accidente:

LOCATION OF ACCIDENT/UBICACION DEL ACCIDENTE __________________________________________

Job site – Facility/ Sitio De Trabajo : __________________________________________

Name & Address/Nombre y Direccion __________________________________________

What were you doing at the time of the accident? (Please be specific. Name machine, tool, vehicle, substance, etc.):

Que estaba haciendo en el momento que ocurrio el accidente? (Por favor, especifique. Mencione maquinaria, herramienta,

vehiculo, substancia, etc.)__________________________________________________________________________________

_______________________________________________________________________________________________________

Describe in your own words how the accident occurred (Please be specific. Name machine, tool, vehicle, substance, etc.):

Describa en sus propias palabras como ocurrio el accidente. (Por favor, especifique. Mencione maquinaria, herramienta,

vehiculo, substancia, etc.)___________________________________________________________________________________

________________________________________________________________________________________________________

What was the injured person doing when the injury/illness occurred?

Que estaba haciendo la persona lesionada cuando la lesion o enfermedad ocurrio?_____________________________________

______________________________________________________________________________

WITNESS ACCIDENT STATEMENT

DECLARACION DEL TESTIGO QUE PRESENCIO EL ACCIDENTE

Benchmark Administrators, LLC7881 W. Charleston Blvd.

Suite 210Las Vegas, NV 89117

Telephone (702) 873-5115 Toll free (800) 362- 5198Fax (702) 876-5584

OVER

Page 10: Please send the Form C3 and the medical slip to

Injured worker must sign & return to employer’s office.

Employer returns to Benchmark Administrators, LLC.

Injured Worker Accident Statement Page 2 of 2

Continued Describe the injury/illness:

Describa la lesion o enfermedad: ____________________________________________________________________________

________________________________________________________________________________________________________

Specifically, what did anyone do, or fail to do, that caused the accident:

Especifique claramente que hicieron o dejaron de hacer las demas personas para que este accidente ocurriera?

________________________________________________________________________________________________________

________________________________________________________________________________________________________

What did you do after the accident?

Que hizo usted despues del accidente?_________________________________________________________________________

Were there any other witnesses? Yes/Si No

Hubo algun otro testigo?

If “YES,” give names and addresses or means of contact to them:

Si asi fue, favor de facilitar nombres, direcciones o algun otro metodo para obtener informacion adicional:

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Did you seek medical attention? Yes/Si No

Solicito usted atencion medica?

If “YES,” when:

Si contesto SI, cuando:_____________________________________________________________________________________

Physician’s name and address:

Nombre del Medico y direccion:______________________________________________________________________________

How can this type of accident be avoided in the future?

Como se podria evitar este tipo de accidente en el futuro? _________________________________________________________

________________________________________________________________________________________________________

I understand that falsification of this statement, or any misrepresented information contained in this statement, can result in disciplinary action.

Entiendo que falsificacion de esta declaracion o dar informacion erronea en esta declaracion puede resultar en accion disciplinaria

____________________________________ ____________________

Signature/Firma Date/Fecha

WITNESS ACCIDENT STATEMENT

DECLARACION DEL TESTIGO QUE PRESENCIO EL ACCIDENTE

Page 11: Please send the Form C3 and the medical slip to

FULL DUTY JOB ANALYSIS / ESSENTIAL DEMANDS

Name: __________________________________________________ Date: _________________________________

Employer: ________________________________________ Department: _________________________________

Job Title: _________________ Soc. Sec. #: _______________Claim No.: __________________________________

Supervisor (Name & Title): _______________________________________________________________________

Purpose of Department Work: ____________________________________________________________________

Essential Job Functions (machines, tool and equipment used): ________________________________________

_______________________________________________________________________________________________

Work Shift: _____________________________ Days per week: _________________________________________

Overtime: _______________________________ Location (City): _________________________________________

WORK POSTURE REQUIREMENTS

N/A 1-25% 25-49% 50-74% 75-100%

Sitting __________ __________ __________ __________ _________

Standing __________ __________ __________ __________ _________

Walking __________ __________ __________ __________ _________

Driving __________ __________ __________ __________ _________

Bending (at waist) __________ __________ __________ __________ _________

Crouching (squat) __________ __________ __________ __________ _________

Kneeling __________ __________ __________ __________ _________

Crawling __________ __________ __________ __________ _________

Climbing __________ __________ __________ __________ _________

Twisting __________ __________ __________ __________ _________

Reaching __________ __________ __________ __________ _________

Balancing __________ __________ __________ __________ _________

Throwing __________ __________ __________ __________ _________

Stretching __________ __________ __________ __________ _________

Wrist Motion __________ __________ __________ __________ _________

(repetition, flexion / rotation)

Feet (foot pedals) __________ __________ __________ __________ _________

Benchmark Administrators, LLC7881 W. Charleston Blvd.,

Suite 210Las Vegas, NV 89117

Telephone (702) 873-5115 Toll free (800) 362- 5198

Fax (702) 876-5584

Page 12: Please send the Form C3 and the medical slip to

CARRYING REQUIREMENTS

Items Carried: ___________________________________________________________________________

Distance:_____________________________________ Times per Day: ____________________________

How Carried: ____________________________________________________________________________

Average Weight Carried:______________# Times per Day: ____________________________

Maximum Weight Carried:____________# Times per Day: ____________________________

Items Carried on Person:__________________________________________________________________

LIFTING REQUIREMENTS

Items Lifted:__________________________________ Times per Day: ____________________________

Average Weight Lifted:_______________# Times per Day: ____________________________

Maximum Weight Lifted:_____________# Times per Day: ____________________________

LIFTING LEVELS / HEIGHTS

Floor Knee Waist Chest Overhead Times per Day _________

The heaviest weight lifted while either sitting or standing in one place weighs:__________#

And the object’s name is:___________________________________________________________.

PUSH / PULL REQUIREMENTS

Items Pushed: _______________________________ Items Pulled: _____________________________

Times per Day: ______________________________ Times per Day: _____________________________

ENVIRONMENTAL CONDITIONS

Inside / Outside Power Equipment Ventilation (good / poor) Hot / Cold Temperatures Electrical Hazard Traffic Hazard Wet Chemical Hazard Explosives Humid Noise Stand on Concrete Cramped Quarters Vibration Walk on Uneven Surfaces Heights Fumes / Odors Dust Moving Objects Other Works with Others / Alone Will you be able to provide modified or alternative work to the injured worker? Yes_____________ No_____________

Define proposed job description: __________________________________________________________

________________________________________________________________________________________

We will provide you with limitations and restrictions upon release from the treating physician. _____________________________________________ _______________________________________ Name of person completing this information sheet Date this form was completed

Page 13: Please send the Form C3 and the medical slip to

LIGHT DUTY JOB ANALYSIS / ESSENTIAL DEMANDS

Name: Date:

Employer: Department:

Job Title: Soc. Sec. #: Claim No.:

Supervisor (Name & Title):

Purpose of Department Work:

Essential Job Functions (machines, tool and equipment used):

Work Shift: Days per week:

Overtime: Location (City):

WORK POSTURE REQUIREMENTS

N/A 1-25% 25-49% 50-74% 75-100%

Sitting

Standing

Walking

Driving

Bending (at waist)

Crouching (squat)

Kneeling

Crawling

Climbing

Twisting

Reaching

Balancing

Throwing

Stretching

Wrist Motion

repetition, flexion / rotation)

Feet (foot pedals)

Benchmark Administrators, LLC7881 W. Charleston Blvd.,

Suite 210Las Vegas, NV 89117

Telephone (702) 873-5115 Toll free (800) 362- 5198

Fax (702) 876-5584

Page 14: Please send the Form C3 and the medical slip to

CARRYING REQUIREMENTS

Items Carried:

Distance: Times per Day:

How Carried:

Average Weight Carried: # Times per Day:

Maximum Weight Carried: # Times per Day:

Items Carried on Person:

LIFTING REQUIREMENTS

Items Lifted: Times per Day:

Average Weight Lifted: # Times per Day:

Maximum Weight Lifted: # Times per Day:

LIFTING LEVELS / HEIGHTS

Floor Knee Waist Chest Overhead Times per Day

The heaviest weight lifted while either sitting or standing in one place weighs: #

And the object’s name is: .

PUSH / PULL REQUIREMENTS

Items Pushed: Items Pulled:

Times per Day: Times per Day:

ENVIRONMENTAL CONDITIONS

Inside / Outside Power Equipment Ventilation (good / poor) Hot / Cold Temperatures Electrical Hazard Traffic Hazard Wet Chemical Hazard Explosives Humid Noise Stand on Concrete Cramped Quarters Vibration Walk on Uneven Surfaces Heights Fumes / Odors Dust Moving Objects Other Works with Others / Alone

Will you be able to provide modified or alternative work to the injured worker?

Yes No

Define proposed job description:

We will provide you with limitations and restrictions upon release from the treating physician.

Name of person completing this information sheet Date this form was completed

Page 15: Please send the Form C3 and the medical slip to

OSHA 300 LOG INFORMATION

Nevada and federal OSHA Regulations require employers with more than 10 employees complete and

maintain a log of recordable on-the-job injuries and illnesses.

This Claim may require entry onto the OSHA 300 Log if the injury/illness results in:

1. A death. Or;

2. Lost time is in excess of one full day (the day of the accident and the first day back to work do not

count). Or;

3. Medical treatment by a physician other than what is considered First Aid. Or;

4. Restricted work activity (LIGHT DUTY). Or;

5. A job transfer due to the injury/illness. Or;

6. Any Loss of Consciousness.

Injured Worker’s Name: _____________________________________

Date of the Accident: _______________________________

Attention: Supervisors and Managers.

If this claim meets one of the above requirements, it should be posted on your Company’s OSHA 300

Log.

Benchmark Administrators, LLC

7881 W. Charleston Blvd., Suite 210

Las Vegas, NV 89117

Tel (702) 873-5115

Toll Free (800) 362 -5198

Fax (702) 8766-5584

Page 16: Please send the Form C3 and the medical slip to

State of Nevada

DEPARTMENT OF BUSINESS & INDUSTRY DIVISION OF INDUSTRIAL RELATIONS

Workers’ Compensation Section

A T T E N T I O N Brief Description of Your Rights and Benefits

If You Are Injured on the Job or have an Occupational Disease

Notice of Injury or Occupational Disease (Incident Report Form C-1) If an injury or occupational disease (OD) arises out of and in the course of employment, you must provide written notice to your employer as soon as practicable, but no later than 7 days after the accident or OD. Your employer shall maintain a sufficient supply of the forms.

Claim for Compensation (Form C-4): If medical treatment is sought, the

form C-4 is available at the place of initial treatment. A completed "Claim

for Compensation" (Form C-4) must be filed within 90 days after an

accident or OD. The treating physician or chiropractor must, within 3

working days after treatment, complete and mail to the employer, the

employer's insurer and third-party administrator, the Claim for

Compensation.

Medical Treatment: If you require medical treatment for your on-the-job injury or OD, you may be required to select a physician or chiropractor from a list provided by your workers’ compensation insurer, if it has contracted with an Organization for Managed Care (MCO) or Preferred Provider Organization (PPO) or providers of health care. If your employer has not entered into a contract with an MCO or PPO, you may select a physician or chiropractor from the Panel of Physicians and Chiropractors. Any medical costs related to your industrial injury or OD will be paid by your insurer.

Temporary Total Disability (TTD): If your doctor has certified that you are unable to work for a period of at least 5 consecutive days, or 5 cumulative days in a 20-day period, or places restrictions on you that your employer does not accommodate, you may be entitled to TTD compensation.

Temporary Partial Disability (TPD): If the wage you receive upon reemployment is less than the compensation for TTD to which you are entitled, the insurer may be required to pay you TPD compensation to make up the difference. TPD can only be paid for a maximum of 24 months.

Permanent Partial Disability (PPD): When your medical condition is stable and there is an indication of a PPD as a result of your injury or OD, within 30 days, your insurer must arrange for an evaluation by a rating physician or chiropractor to determine the degree of your PPD. The amount of your PPD award depends on the date of injury, the results of the PPD evaluation and your age and wage.

Permanent Total Disability (PTD): If you are medically certified by a

treating physician or chiropractor as permanently and totally disabled and

have been granted a PTD status by your insurer, you are entitled to receive

monthly benefits not to exceed 66 2/3% of your average monthly wage.

The amount of your PTD payments is subject to reduction if you previously

received a PPD award.

Vocational Rehabilitation Services: You may be eligible for vocational rehabilitation services if you are unable to return to the job due to a permanent physical impairment or permanent restrictions as a result of your injury or occupational disease.

Transportation and Per Diem Reimbursement: You may be eligible for travel expenses and per diem associated with medical treatment.

Reopening: You may be able to reopen your claim if your condition worsens after claim closure.

Appeal Process: If you disagree with a written determination issued by

the insurer or the insurer does not respond to your request, you may

appeal to the Department of Administration, Hearing Officer, by

following the instructions contained in your determination letter. You

must appeal the determination within 70 days from the date of the

determination letter at 1050 E. William Street, Suite 400, Carson City,

Nevada 89701, or 2200 S. Rancho Drive, Suite 210, Las Vegas, Nevada

89102. If you disagree with the Hearing Officer decision, you may appeal

to the Department of Administration, Appeals Officer. You must file

your appeal within 30 days from the date of the Hearing Officer decision

letter at 1050 E. William Street, Suite 450, Carson City, Nevada 89701, or

2200 S. Rancho Drive, Suite 220, Las Vegas, Nevada 89102. If you

disagree with a decision of an Appeals Officer, you may file a petition

for judicial review with the District Court. You must do so within 30

days of the Appeal Officer’s decision. You may be represented by an

attorney at your own expense or you may contact the NAIW for possible

representation.

Nevada Attorney for Injured Workers (NAIW): If you disagree with a hearing officer decision, you may request that NAIW represent you without charge at an Appeals Officer hearing. NAIW is an independent state agency and is not affiliated with any insurer. For information regarding denial of benefits, you may contact the NAIW at: 1000 E. William Street, Suite 208, Carson City, NV 89701, (775) 684-7555, or 2200 S. Rancho Drive, Suite 230, Las Vegas, NV 89102, (702) 486-2830.

To File a Complaint with the Division: If you wish to file a complaint with the Administrator of the Division of Industrial Relations (DIR), please contact Workers’ Compensation Section, 400 West King Street, Suite 400, Carson City, Nevada 89703, telephone (775)684-7270, or 3360 W. Sahara Ave., Suite 250, Las Vegas, NV 89102, telephone (702) 486-9080.

For Assistance with Workers’ Compensation Issues: You may contact the Office of the Governor Consumer Health Assistance, 555 E. Washington Avenue, Suite 4800, Las Vegas, Nevada 89101, Toll Free 1- 888-333-1597, Web site: http:/govcha.state.nv.us, E-mail [email protected]

The information in this publication is derived from Chapters 616A and 617 of the Nevada Revised Statutes and is provided for informational purposes only. If you have any questions, regarding your injury or workers' compensation claim, please call thefollowing:

Insurer/Administrator: Benchmark Administrators, LLC Contact Person: Dave Oakden

Address: 7881 W. Charleston Blvd. #210, Las Vegas, NV 89117 Telephone Number: 800-362-5198 City State Zip

MCO/Health Care Provider: Injury Care of Nevada Contact Person: Loretta Gubler

Address: P.O. Box 62118, Las Vegas, NV 89162 Telephone Number: 702-431-0765 City State Zip D-1 (rev. 6/18)

Page 17: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Urgent Care Pahrump Advanced Medical Center 1501 E. Calvada Blvd. 89048 (775) 727-5509

Urgent Care Las Vegas Advanced Urgent Care 9975 S. Eastern Ave. #110 89123 (702) 361-2273

Urgent Care Boulder City Advanced Urgent Care 999 Adams Blvd. #102 89053 (702) 361-2273

Urgent Care No Las Vegas Bazemore, Curtis MD Ltd 6424 Losee Rd., ste #100 89031 (702) 677-2273

Urgent Care Henderson Concentra Medical Centers 149 N. Gibson Ave. #13 89074 (702) 558-6275

Urgent Care No Las Vegas Concentra Medical Centers 151 W. Brooks Ave. 89030 (702) 399-6545

Urgent Care Las Vegas Concentra Medical Centers 3900 Paradise Rd.#V 89169 (702) 369-0560

Urgent Care Las Vegas Concentra Medical Centers (24hrs) 5850 S. Polaris Ave. #100 89118 (702) 739-9957

Urgent Care Las Vegas Concentra Medical Centers (drug screen only) 2952 Meade Ave. 89102 (702) 871-1721

Urgent Care No Las Vegas Concentra Medical Centers (drug screen only) 3945 W. Cheyenne Ave. #208 89032 (702) 648-8116

Urgent Care Las Vegas Desert Inn Medical Ctr. 1900 E. Desert Inn Rd. 89169 (702) 735-1960

Urgent Care Las Vegas Elite Medical Center 150 E. Harmon Ave. 89109 (702) 546-0911

Urgent Care Las Vegas Emergency Medicine Las Vegas Staffing 150 E. Harmon Ave. 89109 (702) 546-0911

Urgent Care Mesquite Hartwell, Phillip, MD 190 E. Mesquite Blvd. #I 89027 (702) 346-4234

Urgent Care Henderson Healthcare Partners Medical Group 129 W. Lake Mead #10 89015 (702) 565-1007

Urgent Care No Las Vegas Healthcare Partners Medical Group 1302 W. Craig Rd. 89032 (702) 657-9555

Urgent Care Henderson Healthcare Partners Medical Group 1397 Galleria Dr. 89014 (702) 436-5800

Urgent Care Pahrump Healthcare Partners Medical Group 1397 South Loop Rd. 89048 (775) 727-5000

Urgent Care Las Vegas Healthcare Partners Medical Group 4730 Fort Apache Rd. #150 89147 (702) 940-1570

Urgent Care Las Vegas Healthcare Partners Medical Group (24 hr) 4880 S. Wynn Rd. 89103 (702) 871-5005

Urgent Care Henderson Johnson, Joseph W., MD 800 N. Gibson Rd. 89011 (702) 565-8911

Urgent Care Henderson Legacy Urgent Care 105 N. Pecos Rd. #111 89074 (702) 263-4555

Urgent Care Mesquite Mesquite Medical Associates 1301 Bertha Howe Ave. #1 89027 (702) 346-0800

Urgent Care No Las Vegas Nicknam, Amir, MD/ Southern Nevada Occu Health 4060 N. Martin Luther King Blvd #101 89032 (702) 380-1712

Urgent Care Las Vegas Patel, Anil M., MD/ University Urgent Care 2628 W. Charleston Blvd. 89102 (702) 644-0500

Urgent Care Las Vegas Shah, Dipti R., MD/ University Urgent Care 2628 W. Charleston Blvd. 89102 (702) 644-0500

Urgent Care Las Vegas Shah, Russell J., MD/ University Urgent Care 2628 W. Charleston Blvd. 89102 (702) 644-0500

Urgent Care Las Vegas Southern Nevada Occupational Health Ctr 1712 Bearden Dr. 89106 (702) 733-6622

Urgent Care No Las Vegas Southern Nevada Occupational Health Ctr 4060 N. Martin Luther King Blvd #101 89032 (702) 380-1712

Urgent Care Las Vegas Southwest Medical Associates 2316 W. Charleston Blvd. 89102 (702) 877-5199

Urgent Care Las Vegas Southwest Medical Associates 2704 N. Tenaya Way 89128 (702) 877-5199

Urgent Care Las Vegas Southwest Medical Associates 4475 S. Eastern Ave. 89132 (702) 877-5199

Urgent Care Las Vegas Southwest Medical Associates 5580 W. Flamingo Rd. 89103 (702) 877-5199

Urgent Care Boulder City Southwest Medical Associates 806 Buchanan Blvd. 89005 (702) 877-5199

Urgent Care Las Vegas Southwest Medical Associates 888 S. Rancho Dr. 89125 (702) 877-8600

Urgent Care No Las Vegas Templar, Kevin, MD/ Southern Nevada Occu Health 4060 N. Martin Luther King Blvd #101 89032 (702) 380-1712

Urgent Care Las Vegas The Ctr for Occu Health & Wellness 801 S. Rancho Dr. #F1 89106 (702) 474-4454

Urgent Care Henderson The Ctr for Occu Health & Wellness 9005 S. Pecos Rd. #2600 89074 (702) 474-0472

Urgent Care Las Vegas Urgent Care Centers of Nevada 2285 E. Flamingo Rd. #104 89119 (702) 862-8226

Hospital Las Vegas Desert Springs Hospital 2075 E. Flamingo Rd. 89119 (702) 733-8800

Hospital Las Vegas Mountainview Hospital 3100 N. Tenaya Way 89128 (702) 255-5000

Hospital No Las Vegas North Vista Hospital 1409 E. Lake Mead Blvd. 89030 (702) 649-7711

Hospital Las Vegas Spring Valley Hospital 5400 S. Rainbow Blvd. 89118 (702) 853-3000

Hospital Henderson St. Rose Dominican Hosp-Rose De Lima 102 E. Lake Mead Pkwy. 89015 (702) 564-2622

Hospital Las Vegas St. Rose Dominican Hosp-San Martin 8280 W. Warm Springs Rd. 89113 (702) 492-8000

Hospital Henderson St. Rose Dominican Hosp-Siena 3001 St. Rose Parkway 89052 (702) 616-5000

Hospital Las Vegas Summerlin Hospital 657 N. Town Center Dr. 89134 (702) 233-7000

Hospital Las Vegas Sunrise Hospital 3186 S. Maryland Pkwy. 89109 (702) 731-8000

Hospital Las Vegas University Medical Center 1800 W. Charleston Blvd. 89102 (702) 383-2000

Hospital Las Vegas Valley Hospital 620 Shadow Ln. 89106 (702) 388-4000

Hospital- Rehab Las Vegas Advanced Health Care of Summerlin 2860 N. Tenaya Way 89128 (702) 910-3800

Hospital-Rehab Las Vegas AMG Specialty Hospital, LLC 4015 S. McLeod Dr. 89121 (702) 433-2200

Hospital-Rehab Las Vegas Care Meridian 7690 Carmen Blvd. 89128 (702) 255-7399

Hospital-Rehab Las Vegas Complex Care Hospital at Tenaya 2500 N. Tenaya Way 89128 (702) 562-2021

Hospital-Rehab Las Vegas Desert Canyon Rehab Hospital 9175 W. Oquendo 89148 (702) 252-7342

Hospital-Rehab Las Vegas Horizon Specialty Hospital 640 S. Martin Luther King Blvd. 89106 (702) 382-3155

Hospital-Rehab Henderson Rehab Hosp Henderson (Healthsouth) 10301 Jeffreys St. 89052 (702) 939-9400

Hospital-Rehab Las Vegas Rehab Hosp Las Vegas (Healthsouth) 1250 S. Valley View Blvd. 89102 (702) 877-8898

Hospital-Rehab Las Vegas Solutions Recovery, Inc. 2975 S. Rainbow #E 89146 (702) 228-8520

Acupuncture Las Vegas Lok, Peter 1818 E. Desert Inn Rd. 89169 (702) 732-0178

Ambulance Service Las Vegas American Medical Response 1200 S. Martin Luther King Blvd. 89102 (702) 384-3400

Anesthesiology Las Vegas Anesthesia Critical Care & Trauma 3153 E. WarmSprings #300 89120 (702) 487-5823

Anesthesiology Las Vegas Anesthesiology Consultants Inc 3010 W. Charleston Bvld. #150 89102 (702) 878-0070

Anesthesiology Las Vegas PBS Anesthesia 7250 Peak Dr. #100 89182 (702) 386-4700

Anesthesiology Las Vegas Professional Anesthesia Consult 3540 W. Sahara Ave. #434 89102 (702) 562-3590

Anesthesiology Las Vegas Surgical Anesthesia Services 8440 W. Lake Mead Blvd. #202 89108 (702) 395-1070

Audiology Las Vegas Fyzical Therapy And Balance Center 401 No. Buffalo Dr., Ste., 120 89145 (702) 341-0606

Audiology Las Vegas Fyzical Therapy And Balance Center 9005 S. Pecos Rd. #2520 89074 (702) 880-1515

Audiology Las Vegas Fyzical Therapy And Balance Center 9070 W. Cheyenne Ave. #100 89129 (702) 880-1515

Audiology Henderson Heppler Audio/ Advanced Audiology Institute 10410 S. Eastern Ave., # 110 89052 (702) 853-7986

Audiology Las Vegas Heppler Audio/ Advanced Audiology Institute 9080 W. Cheyenne Ave # 110 89129 (702) 853-7986

Burn Specialist Las Vegas Desert West Surgery 1111 Shadow Ln 89102 (702) 383-4040

Burn Specialist Las Vegas Desert West Surgery 7200 Cathedral Rock Dr. #250 89128 (702) 383-4040

Burn Specialist Las Vegas Desert West Surgery 9260 W. Sunset Rd. #206 89148 (702) 383-4040

Burn Specialist Las Vegas Lewis, Terry R., MD/ Desert West Surgery 1111 Shadow Ln 89102 (702) 383-4040

Burn Specialist Las Vegas Lovett, James V., MD/ Desert West Surgery 1111 Shadow Ln 89102 (702) 383-4040

Cardiology/Surgery Las Vegas Chanderraj, Raj, MD/ NV Heart & Vascular Ctr 4275 Burnham Ave. #100 89119 (702) 240-6482

Cardiology/Surgery Pahrump Healthcare Parnters/ Cardiology 10105 Banbury Cross Dr. # 250 89144 (702) 731-8224

This provider list is subject to change without prior notice page 1

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INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Cardiology/Surgery Las Vegas Healthcare Parnters/ Cardiology 3131 La Canada St. #200 89109 (702) 731-8224

Cardiology/Surgery Las Vegas Healthcare Parnters/ Cardiology 9280 W. Sunset Rd. #320 89148 (702) 731-8224

Cardiology/Surgery Las Vegas Healthcare Partners/ Cardiology 2865 Sienna Heights Dr. 89052 (702) 731-8224

Cardiology/Surgery Las Vegas Healthcare Partners/ Cardiology 330 Lola Ln. Ste. #200 89048 (702) 731-8224

Cardiology/Surgery Las Vegas Las Vegas Cardiology aka Kittusamy, LLP 401 N. Buffalo Dr. #100 89145 (702) 489-9000

Chiropractic Las Vegas Fallon, Nancy, DC 2725 S. Jones Blvd. #105 89146 (702) 248-4488

Chiropractic No Las Vegas Fife, Brian K., DC/ Advanced Chiro Specialists 4116 W. Craig Rd. #100 89032 (702) 655-1199

Chiropractic Las Vegas Stanley, Barry, DC/ Elite Healthcare 2901 El Camino Ave. #100 89102 (702) 858-1259

Chiropractic Las Vegas Valencia Sports and Family Chiropractic 235 N. Eastern Ave. 89101 (702) 307-4004

Dental Las Vegas Wagner Ronald DDS 2045 Village Center Circle 89134 (702) 878-5599

Dental Surgery Las Vegas Orr, Daniel L., DDS 2040 W. Charleston Blvd. #201 89102 (702) 383-3711

Dermatology Las Vegas Thomas Dermatology 9097 W. Post Road, Suite 100 89148 (702) 430-5333

Durable Med Equip Las Vegas AA Medical 4135 N. Rancho Rd. 89130 (702) 368-4477

Durable Med Equip Las Vegas Advanced Prosthetics and Orthotics 1505 Wigwam Pkwy #340 89074 (702) 260-0467

Durable Med Equip Las Vegas Advanced Prosthetics and Orthotics 7455 W. Washington Ave. Ste. 215 89128 (702) 256-5265

Durable Med Equip Las Vegas Care Rehab Flamingo/Paradise 89102

Durable Med Equip Las Vegas Carefree Footwear 1618 E. Charleston Blvd. 89104 (702) 384-5121

Durable Med Equip Las Vegas Cypress Care, Inc --- (800) 419-7191

Durable Med Equip Las Vegas Dynasplint Systems 770 Ritchie Hwy, ste W-21, Severna Oark, MD21146 (800) 638-6771

Durable Med Equip Henderson Hanger Prosthetics & Orthotics West 2625 Wigwam Pkwy. #102 89074 (702) 614-5232

Durable Med Equip Las Vegas Hanger Prosthetics & Orthotics West 4615 W. Flamingo Rd., 89103 (702) 262-1353

Durable Med Equip Las Vegas Hanger Prosthetics & Orthotics West 7250 Peak Dr. #120 89128 (702) 360-9162

Durable Med Equip Las Vegas JAS -Joint Active Systems --- (800) 879-0117

Durable Med Equip Las Vegas KCI ---

Durable Med Equip Las Vegas LifeCare Medical Supplies 3050 E. Desert Inn Rd. #124 89121 (702) 696-1527

Durable Med Equip Las Vegas Orthopedic Motion, Inc. 3233 W. Charleston Bvld. #111 89102 (702) 822-6801

Durable Med Equip Las Vegas Orthopedic Motion, Inc. 653 N. Town Center Dr. #507 89144 (702) 697-7070

Durable Med Equip Las Vegas PMSI ---

Durable Med Equip Henderson Precision Orthotics & Prosthetics 526 S. Tonopah Dr. #120 89106 (702) 243-7671

Durable Med Equip Las Vegas Precision Orthotics & Prosthetics 8915 S. Pecos Rd. #18A 89074 (702) 293-5502

Durable Med Equip Pahrump Preferred Homecare (Founders Healthcare) 1840 Calvada Lane #1 89048 (775) 727-8844

Durable Med Equip Las Vegas Prosthetic Center Of Excellence 400 Shadow Ln. #110 89106 (702) 384-1410

Durable Med Equip Las Vegas RS Medical 14001 SE First St., 89684 (800) 935-7763

Durable Med Equip Las Vegas Team Surgical/Restore Mortion 27051 Towne Centre Dr., 92610 (949) 474-1753

Durable Med Equip Las Vegas Vertical Xpressions ---

Durable Med Equip Las Vegas Vision Quest dba VQ Orthocare --- (800) 266-6969

Durable Med Equip Las Vegas Vital Care 3127 W. Post Rd. 89118 (888) 895-5798

Durable Med Equip CA RAM Durable Medical Equipment/ SCORE 7909 Silverton Ave. #214 92126 (858) 549-1771

Ear, Nose & Throat No Las Vegas 1905 McDaniel St. Ste. 104 89030 (702) 838-9710

Ear, Nose & Throat Las Vegas Foggia, David A. MD/ Ear, Nose & Throat Consultants 3195 St. Rose Pkwy #210 89052 (702) 792-6700

Ear, Nose & Throat Las Vegas Goll, Frederick MD/ Ear, Nose & Throat Consultants 3195 St. Rose Pkwy #210 89052 (702) 792-6700

Ear, Nose & Throat Las Vegas Lubritz, Joel N., MD (nasal fracture only) 3201 S. Maryland Pkwy. #300 89109 (702) 732-4491

Ear, Nose & Throat Las Vegas Nevada Eye Physicians 2020 Goldring Medical Plaza #401 89106 (702) 896-6043

Ear, Nose & Throat Henderson Nevada Eye Physicians 2598 Windmill Pkwy. 89074 (702) 896-6043

Ear, Nose & Throat Las Vegas Schroeder, Walter W. MD/ Ear, Nose & Throat Consultants 3195 St. Rose Pkwy #210 89052 (702) 792-6700

Ear, Nose & Throat Henderson Schwartz, Susan E., DO 8985 S. Pecos Rd. #3B 89074 (702) 647-2900

Ear, Nose & Throat Las Vegas Sikand, Ashley, MD/ Ear, Nose & Throat Consultants 8840 W. Sunset Rd. #A 89052 (702) 792-6700

Ear, Nose & Throat Henderson Yu, Larry M. MD/ Ear, Nose & Throat Consultants 3195 St. Rose Pkwy. #210 89052 (702) 792-6700

Emer Phys Group Las Vegas Emergency Physicians Med Group --- (916) 960-2000

Emer Phys Group Las Vegas Fremont Emergency Services --- (702) 382-5200

Emer Phys Group Las Vegas Shadow Emergency Physicians 1050 Galleria Dr. 89011 (800) 355-2470

Emer Phys Group Las Vegas UNSOM 1701 W. Charleston Blvd. #215 89102 (702) 671-2330

Endocrinology Las Vegas Kidney Specialists of So. NV/ Nephrology & Endocrine Assoc. 500 S. Rancho Ste. #12 89106 (702) 877-1887

Gastroenterology Las Vegas Gastroenterology Associates 3820 S. Hualapai Way #200 89137 (702) 796-0231

Gastroenterology Henderson Gastroenterology Center of Nevada 98 E. Lake Mead Dr. #302 89015 (702) 565-3037

General Medicine Henderson Kim, Sungwook S., MD/ Brighton Family Med 213 W. Stephanie St. #100 89012 (702) 566-5445

General Surgery Las Vegas Advanced Laparscopic and General Surgery of NV 6240 No. Durango Dr. Ste. 120 89149 (702) 791-855

General Surgery Las Vegas Advanced Surgical Associates/ O'Bringer, PA 11413 Perugino Dr. 89138 (702) 290-2040

General Surgery Las Vegas Banich, Terence, MD/ General Surgery Associates 700 Shadow Ln. #370 89106 (702) 382-8222

General Surgery Las Vegas Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

General Surgery Las Vegas Desert West Surgery 7200 Cathedral Rock Dr. #250 89128 (702) 383-4040

General Surgery Las Vegas Desert West Surgery 9260 W. Sunset Rd. #206 89148 (702) 383-4040

General Surgery Henderson Dort, Sean D., MD/ Southern Nevada Surgery Specialists 10001 S. Eastern Ave. #200 89052 (702) 914-2420

General Surgery Las Vegas Fusco, Arthur, MD/ General Surgery Associates 700 Shadow Ln. #370 89106 (702) 382-8222

General Surgery Las Vegas General Surgery Associates 5380 S. Rainbow Blvd. #210 89118 (702) 382-8222

General Surgery Las Vegas General Surgery Associates 700 Shadow Ln. #370 89106 (702) 382-8222

General Surgery Henderson Knoblock, Lyn A., MD/ Southern Nevada Surgery Specialists 10001 S. Eastern Ave. #200 89052 (702) 914-2420

General Surgery Las Vegas Lewis, Terry R., MD/ Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

General Surgery Las Vegas Lovett, James V., MD/ Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

General Surgery Las Vegas Ozobia, Nathan, IBE MD/ UMC Trauma 5701 W. Charleston Blvd. Ste., #105 89146 (702) 643-0500

General Surgery Henderson Ripplinger, Gregg M., MD/ Southern Nevada Surgery Specialists10001 S. Eastern Ave. #200 89052 (702) 914-2420

General Surgery Las Vegas Simon, Irwin B, MD 2450 W. Horizon Ridge Pkwy. #100 89052 (702) 735-2305

General Surgery Henderson Southern Nevada Surgery Specialists 10001 S. Eastern Ave. #200 89052 (702) 914-2420

General Surgery Henderson Walton, Charles B., MD/ Southern Nevada Surgery Specialists 10001 S. Eastern Ave. #200 89052 (702) 914-2420

Hand Surgery Las Vegas Bronstein, Andrew J., MD/ The Bronstein Hand Ctr. 10135 W. Twain Ave. #100 89147 (702) 458-4263

Hand Surgery Henderson Bronstein, Andrew J., MD/ The Bronstein Hand Ctr. 9005 S. Pecos Rd. #2600 89074 (702) 458-4263

Hand Surgery Las Vegas Fadell, David MD/ Hand Surgery Specialists of Nevada 4530 S. Eastern Ave. #1 89119 (702) 645-7800

Hand Surgery Las Vegas Gluek, George, MD/ Hand Center of Nevada 8585 S. Eastern Ave. #100 89123 (702) 798-8585

This provider list is subject to change without prior notice page 2

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INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Hand Surgery Las Vegas Golshani, Kevin R. MD/ Nevada Orthopedic & Spine 7455 W. Washington Ave. #160 89128 (702) 258-3773

Hand Surgery Las Vegas Grabow, Ryan J., MD/ Hand to Shoulder Center 3175 St. Rose Pkwy. Ste. #330 89052 (702) 433-9533

Hand Surgery Las Vegas Gutierrez, Robert C., MD 400 N. Stephanie Ste., #310 89014 (702) 458-4263

Hand Surgery Las Vegas Jones, Jedidiah MD/ Hand Surgery Specialists of Nevada 4530 S. Eastern Ave. #1 89119 (702) 645-7800

Hand Surgery Las Vegas Lee, Michael, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Hand Surgery Las Vegas Micev, Alan MD/ Hand Center Of Nevada 8585 S. Eastern Ave. #100 89123 (702) 798-8585

Hand Surgery Las Vegas Song, Walter J. MD/ Nevada Ortho 7455 W. Washington Ave. #160 89128 (702) 258-3773

Hand Surgery Las Vegas Sorelle, Jonathan R., MD 8960 W. Tropicana Ave. #500 89147 (702) 458-4263

Hand Surgery Las Vegas Stewart, William T., MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Hand Surgery Las Vegas Taylor, Arthur, MD/ Taylor Ortho Clinic 7455 W. Washington Ave. #160 89128 (702) 878-0393

Hand Surgery Henderson Tollestrup, Timothy W. MD/ Neuropax Clinic of Nev 3035 W. Horizon Ridge Pkwy #120 89052 (702) 684-5502

Hand Surgery Henderson Tollestrup, Timothy W. MD/ Neuropax Clinic of Nev 3035 W. Horizon Ridge Pkwy #120 89052 (702) 684-5502

Hand Surgery Las Vegas Vahey, James W., MD/ The Hand Center Of Nevada 8585 S. Eastern Ave. #100 89123 (702) 798-8585

Hand Surgery Las Vegas Williams, Carl N. Jr. MD 2020 Goldring Ave. #504 89106 (702) 259-3223

Hand Surgery Las Vegas Young, Colby P.. MD/ Hand Surgery Specialists of Nevada 4530 S. Eastern Ave. #1 89119 (702) 645-7800

Hand Surgery Henderson Yu, Conrad O., MD/ Nevada Ortho & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Home Health Care Las Vegas A & E Home Health Care, LLC 3160 S. Valley View Blvd. #202 89102 (702) 258-4181

Home Health Care Las Vegas Critical Care Systems ---

Home Health Care Henderson Good Shepherd Integrated Healthcare Systems 2821 W.Horizon Ridge Pkwy, Ste. #101 89052 (702) 893-0960

Home Health Care Las Vegas Meadows Home Health Services 3750 S. Jones Blvd. #140 89103 (702) 403-4415

Home Health Care Las Vegas NurseCore of Las Vegas 4423 W. Flamingo Rd 89103 (702) 458-1137

Home Health Care Las Vegas Preferred Homecare (Founders Healthcare) 871 Grier Dr. #B-2 89119 (702) 951-6900

Home Health Care Las Vegas Professional Healthcare Staffing dba Prof Healthcare Services 2820 W. Charleston Blvd. #36 89102 (702) 362-0711

Home Health Care Las Vegas Valley View Home Health Care LLC. 6767 W. Charleston Blvd. Ste. 150 89146 (702) 463-1100

Infectious Disease Las Vegas Clinical Infectious Diseases Specialists 2435 Fire Mesa St. #128 89128 (702) 968-2437

Infectious Disease Las Vegas Hruska, Jerome, MD/ Infectious Diseases Consultants 3006 S. Maryland Pkwy. #780 89109 (702) 737-0740

Infectious Disease Las Vegas Infectious Diseases Consultants 3006 S. Maryland Pkwy. #780 89109 (702) 737-0740

Infectious Disease Las Vegas Skankey, Gary, MD/ Infectious Diseases Consultants 3006 S. Maryland Pkwy. #780 89109 (702) 737-0740

Infectious Disease Las Vegas Speck, Eugene, MD/ Infectious Diseases Consultants 3006 S. Maryland Pkwy. #780 89109 (702) 737-0740

Internal Medicine Las Vegas Bashy, Majid H., MD/ Vein Clinic of Las Vegas 3309 W. Charleston Blvd. 89102 (702) 838-0444

Internal Medicine Las Vegas Emery, Paul T., MD 8205 W. Warm Springs Rd. #210 89113 (702) 228-4088

Internal Medicine Henderson Lee, Brian E., MD/ Southeren Nev Internists 4409 S. Pecos Rd. 89121 (702) 434-6336

Internal Medicine Las Vegas Rohani, Ardeshi, MD 3824 S. Jones Blvd. Ste. A 89103 (702) 463-3000

Internal Medicine Las Vegas Serru Paez, Antonio, MD/ Caring Health Center 4424 S. Eastern Ave 89119 (702) 732-7440

Internal Medicine Las Vegas Urgent Care Centers of Nevada 2285 E. Flamingo Rd. #104 89119 (702) 862-8226

Internal Medicine Las Vegas Velazquez, Ricardo, MD 2010 Walnut Way #308 89106 (702) 399-8808

Knee Surgery Las Vegas Allen, Mark DO/ Nevada Orthopedic & Spine 7455 W. Washington Pkwy #330 89128 (702) 878-0393

Knee Surgery Henderson Ashman, Edward S., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Las Vegas Balduff, John, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Knee Surgery Henderson Baker, Bradley, MD/ Nevada Orthopedic & Spine Center 7455 W. Washington Ave. #160 89128 (702) 258-3773

Knee Surgery Henderson Bradford, Michael S., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Las Vegas Fontes, Roger A. MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Knee Surgery Las Vegas Fouse, Matthew, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Knee Surgery Las Vegas Hanson, Chad, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Knee Surgery Henderson Hillock, Ronald, MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Las Vegas Huff Jr., Lawrence, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Knee Surgery Las Vegas Kang, Parminder S. MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Knee Surgery Las Vegas Kastrup, John MD/ Nevada Orthopedic & Spine Center 7455 W. Washington Ave. #160 89128 (702) 878-0394

Knee Surgery Henderson Kim, Thomas C., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Las Vegas Manning, James B., MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Knee Surgery Las Vegas Mendez, Kirk MD/ Bone and Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-0009

Knee Surgery Las Vegas Miao, Michael, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Knee Surgery Henderson Morris, Gary D., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Henderson Nevins, Russell T., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Henderson Rimoldi, Reynold L., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Knee Surgery Las Vegas Rosen, Mark J., MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Knee Surgery Las Vegas Sanders, Steven, MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Nephrology Las Vegas Bernstein, Marvin, MD/ Nephrology & Endocrine Assoc. 500 S. Rancho Ste. #12 89106 (702) 877-1887

Nephrology Las Vegas Kidney Specialists of So. NV/ Nephrology & Endocrine Assoc. 500 S. Rancho Ste. #12 89106 (702) 877-1887

Nephrology Las Vegas Lehrner, Lawrence M., MD/ Nephrology & Endocrine Assoc. 500 S. Rancho Ste. #12 89106 (702) 877-1887

Neurology Las Vegas Chopra, Gobinder S., MD 6410 Medical Center St. #A-100 89148 (702) 796-8500

Neurology Las Vegas Farrow, Simon, MD 2911 N. Tenaya Way #100 89128 (702) 818-3231

Neurology Las Vegas Hyson, Morton I., MD 701 Shadow Ln. Ste. #170 89106 (702) 387-1757

Neurology Las Vegas Milford, Christopher, MD / Silver State Neuro 2585 Montessouri St. #100 89117 (702) 272-0694

Neurology Las Vegas Wangsuwana, Miracle DO/ Sierra Neurology 1707 W. Charleston Blvd., Ste. #220 89102 (702) 671-5070

Neurosurgery Las Vegas Anson, John A., MD/ The Spine & Brain Institute 861 Coronado Center Drive #200 89052 (702) 896-0940

Neurosurgery Las Vegas Duke, Derek A., MD/ The Spine & Brain Institute 861 Coronado Center Drive #200 89052 (702) 896-0940

Neurosurgery Las Vegas Duke, Derek A., MD/ The Spine & Brain Institute 861 Coronado Center Drive #200 89050 (702) 896-0940

Neurosurgery Henderson Flangas, Gary MD/ Las Vegas Neurosurgery & Spine 2875 St. Rose Pkwy #120 89052 (702) 737-7070

Neurosurgery Las Vegas Flangas, Gary MD/ Las Vegas Neurosurgery & Spine 8285 W. Arby Ave. #220 89113 (702) 737-7070

Neurosurgery Las Vegas Forage, James S., MD 8530 W. Sunset Rd. #250 89113 (702) 851-0792

Neurosurgery Las Vegas Kaplan, Stuart S., MD/ Las Vegas Neurosurgery 2471 Professional Ct. 89128 (702) 835-0088

Neurosurgery Las Vegas Las Vegas Neurosurgical 2471 Professional Ct. 89128 (702) 835-0088

Neurosurgery Henderson Nelson, Debra, MD/ Las Vegas Neurosurgery & Spine 2875 St. Rose Pkwy #120 89052 (702) 737-7070

Neurosurgery Henderson Nelson, Debra, MD/ Las Vegas Neurosurgery & Spine 8285 W. Arby Ave. #220 89113 (702) 737-7753

Neurosurgery Las Vegas Nev Brain & Spine Care 9499 W. Charleston Blvd. #270 89117 (702) 994-9236

Neurosurgery Las Vegas Seiff, Michael MD/ The Spine and Brain Institute 861 Coronado Center Drive #200 89502 (702) 896-0940

Neurosurgery Las Vegas Smith, William D., MD/ Western Regional Center for Brain 3061 S. Maryland Pkwy. #200 89109 (702) 851-0792

This provider list is subject to change without prior notice page 3

Page 20: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Neurosurgery Las Vegas The Spine & Brain Institute 8530 W. Sunset Rd. #250 89113 (702) 851-0792

Neurosurgery Henderson The Spine & Brain Institute 861 Coronado Center Drive #200 89052 (702) 896-0940

Ophthalmology Las Vegas Abrams, Jack, MD 6450 Medical Center St. #100 89148 (702) 304-9494

Ophthalmology Las Vegas Brimhall, Brett OD / Brimhall Eye Center 6850 N.. Durango Dr. #110 89149 (702) 263-2020

Ophthalmology Las Vegas Casey, Paul, MD/ Nevada Eye Care Professionals 2090 E. Flamingo Rd. #200 89119 (702) 733-9271

Ophthalmology Las Vegas Debiparshad/ Nevada Eye Physicians 1505 Wigwam Pkwy #100 89074 (702) 896-6043

Ophthalmology Las Vegas Houchin, Kenneth, MD 7530 W. Sahara Ave. #101 89107 (702) 718-2020

Ophthalmology Henderson Hsu, Gregory, DO/ Sunset Eye Center 299 N. Pecos Rd. 89074 (702) 450-6000

Ophthalmology Las Vegas Kelly, Thomas F, MD/ Silver State Eye Care 6080 S. Fort Apache Rd. #100 89148 (702) 309-2015

Ophthalmology Las Vegas Leibowitz, Stephen, MD (lid/orbital fracture only) 653 Town Center Dr. #102 89144 (702) 242-5555

Ophthalmology Las Vegas Little, Loren E., MD/ Nevada Eye Care Professionals 2090 E. Flamingo Rd. #200 89119 (702) 733-9271

Ophthalmology Las Vegas Nevada Eye Care Professionals 2090 E. Flamingo Rd. #200 89119 (702) 733-9271

Ophthalmology Las Vegas Nevada Eye Care Professionals 7730 W. Cheyenne Ave. #103 89129 (702) 869-6326

Ophthalmology Las Vegas Nevada Eye Physicians 1505 Wigwam Pkwy. #101 89074 (702) 896-6043

Ophthalmology Las Vegas Orton, Douglas, OD/ Nevada Eye Physicians 1505 Wigwam Pkwy. #101 89074 (702) 896-6043

Ophthalmology Las Vegas Park, Stewart D., MD/ Nevada Eye Care Professionals 2090 E. Flamingo Rd. #200 89119 (702) 733-9271

Ophthalmology Las Vegas Parker, R. Jeffrey, MD/ Retina Consultants of Nevada 710 Coronado Center Dr. 89052 (702) 369-0200

Ophthalmology Las Vegas Reddy, Archana, MD/ Nevada Eye Care Professionals 2090 E. Flamingo Rd. #200 89119 (702) 733-9271

Ophthalmology Mesquite Retina Consultants of Nevada 1301 Bertha Howe Ave. 89027 (702) 369-0200

Ophthalmology Henderson Retina Consultants of Nevada 2845 Siena Heights Dr. #300 89052 (702) 369-0200

Ophthalmology Las Vegas Retina Consultants of Nevada 3006 S. Maryland Pkwy. #710 89109 (702) 369-0200

Ophthalmology Las Vegas Retina Consultants of Nevada 3006 S. Maryland Pkwy. #710 89109 (702) 369-0200

Ophthalmology Laughlin Retina Consultants of Nevada 3650 S. Point Cir. #210 89029 (702) 369-0200

Ophthalmology Laughlin Retina Consultants of Nevada 3650 S. Pointe Circle #210 89029 (702) 369-0200

Ophthalmology Las Vegas Retina Consultants of Nevada 653 N.Town Center Dr #518 89144 (702) 369-0200

Ophthalmology Henderson Retina Consultants of Nevada 710 Coronado Center Dr. 89052 (702) 369-0200

Ophthalmology Las Vegas Simon, Roger M., MD/ Retina Consultants of Nevada 2845 Siena Heights Dr. #300 89052 (702) 369-0200

Ophthalmology Las Vegas Stein, Emil A., MD/ Nevada Eye Care Professionals 2090 E. Flamingo Rd. #200 89119 (702) 733-9271

Ophthalmology/Retinology Las Vegas Retina Consultants of Nevada 653 N.Town Center Dr #518 89144 (702) 369-0200

Oriental Medicine Las Vegas Lok, Peter 1818 E. Desert Inn Rd. 89169 (702) 732-0178

Orthopedics Henderson Ashman, Edward S., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Advanced Ortho & Sports Medicine 6850 N. Durango Dr. #218 89149 (702) 740-5327

Orthopedics Pahrump Advanced Ortho & Sports Medicine 8420 W. Warm Springs Rd. #100 89113 (702) 740-5327

Orthopedics Las Vegas Allen, Mark DO/ Nevada Orthopedic & Spine 7455 W. Washington Ave. #330 89128 (702) 878-0393

Orthopedics Las Vegas Balduff, John, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Las Vegas Barker, Bradley, MD/ Nevada Orthopedic & Spine Center 7455 W. Washington Ave. #160 89128 (702) 258-3773

Orthopedics Las Vegas Bascharon, Randa, DO 6850 N. Durango Dr. #218 89149 (702) 947-7790

Orthopedics Las Vegas Bascharon, Randa, DO 7281 W. Sahara Ave. #110 89148 (702) 947-7790

Orthopedics Las Vegas Bascharon, Randa, DO (main office) 5735 S. Fort Apache Rd. #B 89148 (702) 947-7790

Orthopedics Las Vegas Bassewitz, Hugh, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Las Vegas Bigler, Gregory T., MD/ Knee and Shoulder Institute 9499 W. Charleston Blvd. #200 89117 (702) 933-9393

Orthopedics Las Vegas Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Orthopedics Las Vegas Bone & Joint Specialists 2680 Crimson Canyon Dr. 89128 (702) 474-7200

Orthopedics Henderson Bradford, Michael S., MD/ Nevada Orthopedic & Spine 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Brandner, Patrick, J., MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Bronstein, Andrew J., MD/ The Bronstein Hand Ctr. 10135 W. Twain Ave. #100 89147 (702) 458-4263

Orthopedics Henderson Bronstein, Andrew J., MD/ The Bronstein Hand Ctr. 9005 S. Pecos Rd. #2600 89074 (702) 458-4263

Orthopedics Las Vegas Carr, Brian MD./ Thomas and Bigler Knee and Shoulder 9499 W. Charleston Blvd. #200 89117 (702) 933-9393

Orthopedics Henderson Chan, Holman, MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Henderson Crovetti, Michael J., DO/ Bone & Joint Institute/ Crovetti Sports 2779 W. Horizon Ridge Pkwy. #200 89052 (702) 990-2290

Orthopedics Las Vegas Dettling, James R., MD 801 S. Rancho Dr. # F-1 & F-2 89106 (702) 877-6781

Orthopedics Las Vegas Dunn, Thomas, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Hanson, Chad, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Las Vegas Elkanich, George, MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Orthopedics Las Vegas Fouse, Matthew, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Kastrup, John MD/ Nevada Orthopedic & Spine Center 7455 W. Washington Ave. #160 8918 (702) 878-0394

Orthopedics Henderson Kim, Thomas C., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Koe, Ronald, MD/ Green Valley Ortho 1710 W. Horizon Ridge Pkwy #120 89102 (702) 990-4555

Orthopedics Las Vegas Las Vegas Neurosurgery, Ortho, Rehab 501 S. Rancho Dr. #I-67 89106 (702) 243-4700

Orthopedics Las Vegas Lee, Michael, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Liberti, Elaine, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Las Vegas Manning, James B., MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Orthopedics Las Vegas Miao, Michael, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Martin, Andrew Scott, MD 5546 S. Fort Apache Rd #100 89148 (702) 898-2663

Orthopedics Las Vegas Matekya, Richard, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Las Vegas McGee Jr., William MD/ Total Sports Medicine 10105 Banburry Cross Dr. #445 89144 (702) 475-4390

Orthopedics Las Vegas McBeath, Robert, MD/ OptumCare Orthopaedics and Spine 4750 W. Oakey Blvd. Ste. 401 89102 (702) 724-8877

Orthopedics Las Vegas McNulty, Patrick S., MD/ Nevada Orthopedic Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Mendez, Kirk MD/ Bone and Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-0009

Orthopedics Las Vegas Miao, Michael, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Monroe, Michael T., MD/ Orthopaedic Specialists of Nevada 3233 W. Charleston Blvd #101 89102 (702) 388-1008

Orthopedics Henderson Morris, Gary D., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Orthopaedic Specialists of Nevada 3233 W. Charleston Blvd #101 89102 (702) 388-1008

Orthopedics Las Vegas Perry, Archie, C., MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Raissi, Abdi, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Henderson Nevins. Russell T., MD/ Nevada Orthopedic & Spine 1505 Wigwam Pkay. #330 89074 (702) 878-0393

Orthopedics Las Vegas Ong, Bernard, MD 8551 W. Lake Mead Blvd. #251 89128 (702) 796-7979

Orthopedics Henderson Otten, Matthew, MD/ Advanced Ortho & Sports Medicine 8420 W. Warm Springs Rd. #100 89113 (702) 740-5327

This provider list is subject to change without prior notice page 4

Page 21: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Orthopedics Las Vegas Patti, Robert, MD/ OccuOrtho Health 2080 E. Flamingo Rd. #301 89119 (702) 734-8876

Orthopedics Las Vegas Perry, Archie, C., MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pwky. #100 89502 (702) 263-9082

Orthopedics Las Vegas Pinegar, Caleb O., DO/ Bone & Joint Inst./ Crovetti Sports 2779 W. Horizon Ridge Pkwy Ste. 200 89502 (702) 990-2990

Orthopedics Las Vegas Ragsdell, Matthew M., DO 5546 S. Fort Apache Rd# 100 89148 (795) 262-2702

Orthopedics Las Vegas Raissi, Abdi, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pwky. #100 89502 (702) 263-9082

Orthopedics Henderson Redfern, Fred C., MD 1701 N Green Valley Pkwy. #4B 89074 (702) 456-2400

Orthopedics Las Vegas Reneau, John, MD/ Las Vegas Neurosurgery, Ortho and Rehab 501 S. Rancho Dr. #I-67 89106 (702) 243-4700

Orthopedics Henderson Rimoldi, Reynold L., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89704 (702) 878-0393

Orthopedics Las Vegas Rosen, Mark J., MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Orthopedics Las Vegas Sanders, Steven, MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Orthopedics Las Vegas Serfustini, Anthony B., MD 501 S. Rancho Dr. #I-65 89106 (702) 733-7855

Orthopedics Las Vegas Shannon, Mary Ann, MD/ Las Vegas Neurosurgery, Ortho and Rehab501 S. Rancho Dr. #I-67 89106 (702) 243-4700

Orthopedics Henderson Sibel, Roman A., MD/ Ortho Foot and Ankle Inst. 3175 St. Rose Pkwy #320 89052 (702) 299-7833

Orthopedics Henderson Sinkov, Vladimir A. MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89075 (702) 878-0393

Orthopedics Las Vegas Stewart, William T., MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Sylvain, Mark G., MD/ Orthopaedic Specialists of Nevada 3233 W. Charleston Blvd #101 89102 (702) 388-1008

Orthopedics Henderson Tait, Robert J., MD/ Orthopaedic Institute of Henderson 10561 Jeffreys St. #230 89052 (702) 565-6565

Orthopedics Henderson Taylor, Arthur J., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Thalgott, John S., MD/ Center For Disease & Surgery Spine 600 S. Rancho Dr. #107 89106 (702) 878-8370

Orthopedics Las Vegas Thomas, Michael D, MD/ Nevada Orthopedic & Spine 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Thomas, Steven C., MD/ Knee and Shoulder Institute 9499 W. Charleston Blvd. #200 89117 (702) 933-9393

Orthopedics Las Vegas Tingey, Craig/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Las Vegas Vahey, James W., MD/ The Hand Center Of Nevada 8585 S. Eastern Ave. #100 89123 (702) 798-8585

Orthopedics Henderson Wallis, Carl B., MD/ Orthopaedic Institute 10561 Jeffreys St. #230 89052 (702) 565-6565

Orthopedics Las Vegas Watson, Troy S., MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Orthopedics Las Vegas Winder, Richard S., MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Orthopedics Henderson Woodworth, Richard S., MD/ Orthopedic Institute of Henderson 10561 Jeffreys St. #230 89502 (705) 565-6565

Orthopedics Las Vegas Wuff, Richard, MD/ Orthopaedic Specialists of Nevada 3233 W. Charleston Blvd #101 89102 (702) 388-1008

Orthopedics Henderson Yee, Randall E., DO/ Advanced Ortho & Sports Medicine 8420 W. Warm Springs Rd #100 89113 (702) 740-5327

Orthopedics Henderson Yu, Conrad O., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Orthopedics Las Vegas Yu, Joseph MD/ Total Sports Medcine 10105 Banburry Cross Dr #445 89144 (702) 475-4390

Pain Management Henderson Advanced Pain Consultants 100 N. Green Valley Pkwy. #320 89074 (702) 731-2642

Pain Management Las Vegas Advanced Pain Consultants 2121 E. Flamingo Rd. #212 89119 (702) 731-2642

Pain Management Las Vegas Advanced Pain Consultants 2650 Crimson Canyon Dr. 89128 (702) 731-2642

Pain Management Henderson Batlan, Daniel., MD/ Specialized Pain Mgmt 1661 W. Horizon Ridge Pkwy Ste. #270 89012 (702) 838-8004

Pain Management Las Vegas Burkhead, Daniel L., MD/ Innovative Pain Care 9920 W. Cheyenne Ave. #110 89129 (702) 316-2281

Pain Management Las Vegas Coppel, Alain, MD/ Nevada Comprehensive Pain Center 2809 W. Charleston Blvd. Ste. 150 89102 (702) 476-9999

Pain Management Las Vegas Ghuman, Babuk, MD/ Nevada Spine Clinic 7140 Smoke Ranch Rd. #240 89128 (702) 320-8111

Pain Management Las Vegas Helmi, Nader DO 6070 S. Fort Apache Rd. #100 89148 (702) 307-7700

Pain Management Las Vegas Jarrett, H. Gregory, DC/ Pain Institute Of Nevada 7435 W. Azure Dr. #190 89106 (702) 878-8252

Pain Management Las Vegas Karno, Grant MD/ NV Comprehesive Pain Center 1569 E. Flamingo Rd. 89119 (702) 476-9999

Pain Management Las Vegas Kim, Daniel K., MD/ Southeren Nevada Pain Center 6950 W. Desert Inn Rd. #110 89117 (702) 259-5550

Pain Management Las Vegas Nagy, Aury, MD/ Nev Brain & Spine Care 2471 Professional Ct., 89128 (702) 901-4233

Pain Management Las Vegas Kucera, Thomas J. MD/ Bone and Joint Inst./ Crovetti Sports 2779 W. Horizon Ridge Pkwy Ste. 200 89502 (702) 990-2290

Pain Management Las Vegas Las Vegas Pain Institute 3835 S. Jones Blvd. #104 89103 (702) 880-4193

Pain Management Las Vegas Las Vegas Spine and Pain Center 2410 Fire Mesa Ste. 160 89128 (702) 676-2000

Pain Management Las Vegas Leon, Raimundo, MD/ Advanced Pain Consultants 100 N. Green Valley Pkwy. #320 89074 (702) 731-2642

Pain Management Las Vegas McKenna, Michael J., MD, PC 6070 S. Fort Apache Rd. #100 89148 (702) 307-7700

Pain Management Las Vegas Nagy, Aury, MD/ Nevada Brain & Spine Care 2471 Professional Ct. 89128 (702) 901-4233

Pain Management Las Vegas Nev Brain & Spine Care 9499 W. Charleston Blvd. #270 89117 (702) 994-9236

Pain Management Las Vegas Schifini, Joseph J., MD 600 S. Tonopah Dr. #240 89106 (702) 870-0011

Pain Management Las Vegas Nevada Comprehensive Pain Center 2809 W. Charleston Blvd. #150 89102 (702) 476-9999

Pain Management Las Vegas Odell, Robert H., PhD/ Neuropathy and Pain Center 8084 w. Sahara Ave. #B 89117 (702) 257-7246

Pain Management Las Vegas Pain Institute of Nevada 7435 W. Azure Dr. #190 89106 (702) 878-8252

Pain Management Las Vegas Parikh, Kunal MD/ NV Comprehensive Pain Center 6990 Smoke Ranch Rd. 89128 (702) 476-9999

Pain Management Las Vegas Perel, Leon MD/ NV Comprehensive Pain Center 6990 Smoke Ranch Rd. 89128 (702) 476-9999

Pain Management Las Vegas Rock, Colin MD/ NV Comprehensive pain Center 1655 W. Horizon Ridge Pkwy 89012 (702) 476-9999

Pain Management Las Vegas Ruggeroli, Anthony C., MD 6070 S. Fort Apache Rd. #100 89148 (702) 307-7700

Pain Management Las Vegas Schifini, Joseph J., MD 600 S. Tonopah Dr. #240 89106 (702) 870-0011

Pain Management Las Vegas Sharma, Satish/ Advanced Pain Management 630 S. Rancho Dr. #H 89106 (702) 739-8323

Pain Management Las Vegas Sharma, Satish/ Advanced Pain Management 9029 S. Pecos Rd. #2800 89074 (702) 739-8323

Pain Management Las Vegas Travnicek, Katherine D. MD/ Pain Institute of Nevada, Inc. 7435 W. Azure Dr. #190 89130 (702) 878-8252

Pathology/Lab Las Vegas Assoc. Pathologists Chtr'd 4330 S. Burnham Ave #250 89119 (702) 733-3725

Pathology/Lab Las Vegas Clia Solutions 10624 S. Eastern Ave. #A637 89052 (702) 869-1919

Pathology/Lab Las Vegas Lab Medicine Consultants 7455 W. Washington Ave. #301 89128 (702) 732-3441

Pathology/Lab Las Vegas Quest Diagnostics/ Associated. Pathologists Labs 4230 S. Burnham Ave. #250 89119 (702) 733-3725

Pharmacy Cypress Care 2736 Meadow Church Rd. 30097 (800) 419-7191

Pharmacy Injury RX LLC 2901 SW 149th Ave. #400 33027 (954) 874-3376

Pharmacy PMSI

Pharmacy Stone River Pharmacy 4425 W. Lake Park Blvd., 84120 (801) 417-6000

Physical Medicine Las Vegas Advanced Spine & Pain Center 601 S. Rancho Dr. #A-6 89106 (702) 386-0909

Physical Medicine Las Vegas Alan Berman, MD/ Rehab Services 9280 W. Sunset Rd. #220 89148 (702) 262-0130

Physical Medicine Las Vegas Chin, Tony Q.F., MD/ Center for Spine & Sports Rehab 3022 S. Durango Dr. #100 89117 (702) 307-1800

Physical Medicine Henderson Chue, Bevins, MD/ Rehab Specilists of Henderson 1669 W. Horizon Ridge Pkwy. #100 89012 (702) 386-1041

Physical Medicine Las Vegas Ezeanolue, D. David, MD/ Apex Medical Ctr 1701 Wellness Way Dr. #200 89106 (702) 310-9110

Physical Medicine Las Vegas Kong, Ronald, MD 501 S. Rancho Dr. #A-5 89106 (702) 382-3331

Physical Medicine Las Vegas Mashhood, Firooz, MD/ Med Rehab Assoc 734 E. Sahara Ave. 89104 (702) 447-7764

Physical Medicine Las Vegas Mohajer, Pouya, MD/ Southern Nevada Pain Specialists 9280 W. Sunset Rd. #412 89148 (702) 798-0111

This provider list is subject to change without prior notice page 5

Page 22: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Physical Medicine Las Vegas Noguiera Trevor, MD 6900 Pecos Rd. 89086 (702) 971-9000

Physical Medicine Las Vegas Pasimio, Edmund, MD/ Adv Spine & Pain 601 S. Rancho Dr. #A-6 89106 (702) 383-3170

Physical Medicine Las Vegas Reed, Mark O., MD, PC 526 S. Tonopah Dr. #160 89106 (702) 383-3170

Physical Medicine Henderson Rehab Specialists of Henderson 1669 W. Horizon Ridge Pkwy. #100 89012 (702) 386-1041

Physical Medicine Henderson Starley, Denice., DO (Tuesday only) 2510 Wigwam Pkwy. #201 89074 (702) 577-7463

Physical Therapy Las Vegas Achieve Physical Therapy 6040 S. Rainbow Blvd. #B-1 89118 (702) 876-9737

Physical Therapy Henderson Anthem Physical Therapy 11201 S. Eastern Ave. #220 89052 (702) 614-0324

Physical Therapy Las Vegas Bartolo Physical Therapy 1801 S. Rainbow Blvd. #230 89146 (702) 243-0055

Physical Therapy Las Vegas Close Physical Therapy 3777 Pecos McLeod # 102 89121 (702) 731-6873

Physical Therapy Henderson Comprehensive Therapy Centers 10561 Jeffreys St. #200 89052 (702) 407-9431

Physical Therapy Pahrump Comprehensive Therapy Centers 1420 E. Calvada #300 89048 (775) 727-4700

Physical Therapy Henderson Comprehensive Therapy Centers 1681 W. Horizon Ridge Pkwy. 89012 (702) 835-0165

Physical Therapy Las Vegas Comprehensive Therapy Centers 3602 E. Sunset Rd. #100 89120 (702) 932-4038

Physical Therapy Las Vegas Desert Inn Medical Ctr. 1900 E. Desert Inn Rd. 89169 (702) 735-1960

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 1500 W. Craig Rd. Ste 210 89147 (702) 360-9142

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 9880 W. Flamingo Rd. Ste 260 89147 (702) 680-0016

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 4885 Blue Diamond Rd. Ste. 210 89139 (702) 207-3770

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 4980 W. Sahara Ave. Ste 260 89146 (702) 820-5070

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 400 No. Stephanie St. 89014 (702) 454-1162

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 750 Coronado Center Dr. 89052 (702) 312-4886

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 2650 No. Tenaya Way 89128 (702) 240-2952

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 4425 So. Pecos Rd. #104 89121 (702) 947-5200

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 6048 So. Durango Dr., Ste 100 89113 (702) 260-6238

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 2904 W. Horizon Ridge Pkwy 89052 (702) 897-7331

Physical Therapy Las Vegas Dignity Select NV/ Select Physical Therapy 821 N. Nellis Blvd. #130 89110 (702) 452-4563

Physical Therapy No Las Vegas Dynamic Spine & Sport 4100 N. Martin Luther King Blvd #A 89032 (702) 380-1712

Physical Therapy Las Vegas Family & Sports Physical Therapy 7351 Prairie Falcon Rd. #100 89125 (702) 968-0520

Physical Therapy Mesquite Fit Physical Therapy / Marchant PT & Wellness 340 Falcon Ridge Pkwy. #500 89027 (702) 346-3105

Physical Therapy Overton Fit Physical Therapy / Marchant PT & Wellness 475 N. Moapa Valley Blvd. 89040 (702) 397-6700

Physical Therapy Henderson FIRST Physical Therapy 6301 Mountain Vista St. Ste. 201 89014 (702) 990-0937

Physical Therapy Las Vegas Fyzical Therapy And Balance Center 401 No. Buffalo Dr. #120 89145 (702) 341-0606

Physical Therapy Las Vegas Fyzical Therapy And Balance Center 9005 S. Pecos Rd. #2520 89074 (702) 880-1515

Physical Therapy Las Vegas Fyzical Therapy And Balance Center 9070 W. Cheyenne Ave. #100 89129 (702) 880-1515

Physical Therapy Las Vegas Green Valley Neck and Back 3663 E. Sunset Rd. #503 89120 (702) 434-2800

Physical Therapy Las Vegas Green Valley Neck and Back 9975 S. Eastern Ave. #110B 89123 (702) 617-4598

Physical Therapy Las Vegas The Hand Center of Nevada 8585 S. Eastern Ave. #100 89123 (702) 798-8585

Physical Therapy Las Vegas Kelly Hawkins PT Works 2080 E. Flamingo Rd. #111 89119 (702) 737-8820

Physical Therapy Las Vegas Kelly Hawkins PT Works 2881 Business Park Ct. #100 89128 (702) 869-6978

Physical Therapy Henderson Kelly Hawkins PT Works 375 N. Stephanie #1111 89014 (702) 456-2024

Physical Therapy Las Vegas Kelly Hawkins PT Works 3753 Howard Huges Pkwy. #141 89109 (702) 737-8820

Physical Therapy Las Vegas Kelly Hawkins PT Works 3831 W.Charleston Blvd. 89103 (702) 876-1733

Physical Therapy No Las Vegas Kelly Hawkins PT Works 3870 W. Ann Road #110 89031 (702) 396-7100

Physical Therapy Las Vegas Kelly Hawkins PT Works 4800 E. Bonanza Rd. #2 89110 (702) 438-3188

Physical Therapy Las Vegas Kelly Hawkins PT Works 7125 Grand Montecito Pkwy #120 89149 (702) 737-8820

Physical Therapy Las Vegas Kelly Hawkins PT Works 8925 W. Russell Rd. #140 89148 (702) 914-6787

Physical Therapy Las Vegas Knee and Shoulder Institute/Steven Thomas 9499 W. Charleston 250 89117 (702) 933-0668

Physical Therapy Mesquite Mesa View Physical Rehabilitation 1140 W Pioneer Blvd. 89027 (702) 346-1899

Physical Therapy Overton Mesa View Physical Rehabilitation 1170 N. Moapa Valley Blvd. #B 89040 (702) 397-2000

Physical Therapy Las Vegas MML Physical Therapy 600 So. Tonopah Dr. #350 89106 (702) 384-6330

Physical Therapy Henderson Optimal/Henderson Physical Therapy 129 W. Lake Mead Pwky. #2 89015 (702) 564-6712

Physical Therapy Las Vegas Orthopaedic Specialists Physical Therapy 3233 W. Charleston Blvd #101 89102 (702) 522-1785

Physical Therapy Henderson Orthosport Physical Therapy 68 N. Pecos Rd. 89074 (702) 597-8999

Physical Therapy Las Vegas Physiotherapy Associates 5920 S. Rainbow Blvd. #1 89118 (702) 248-7906

Physical Therapy Las Vegas Synergy Physical Therapy 1710 W. Horizon Ridge Pkwy #110 89012 (702) 489-9217

Physical Therapy Las Vegas Synergy Physical Therapy 70 E. Horizon Ridge Pkwy. #180 89002 (702) 856-0422

Physical Therapy Las Vegas The Bronstein Hand Ctr. 10135 W. Twain Ave. #100 89147 (702) 458-4263

Physical Therapy Henderson The Bronstein Hand Ctr. 9005 S. Pecos Rd. #2810 89074 (702) 458-4263

Physical Therapy Las Vegas Therapros 4850 W. Flamingo Rd. #25 89103 (702) 871-9918

Physical Therapy Henderson Tim Soder Physical Therapy/ Executive Fitness 2779 W. Horizon Ridge Pkwy. #100 89052 (702) 222-1000

Physical Therapy Las Vegas Tim Soder Physical Therapy/ Executive Fitness 6440 Medical Center St. #100 89148 (702) 222-1000

Physical Therapy Las Vegas Tina Baum Physical Therapy 2880 N. Tenaya Way Ste. #405 89128 (702) 877-2000

Physical Therapy Las Vegas TRU Physical Therapy 70 E. Horizon Ridge Pkwy. #180 89002 (702) 856-0422

Plastic Surgery Las Vegas Glyman, Mark L., MD, DDS 1775 Village Center Circle #150 89134 (702) 507-5555

Plastic Surgery Las Vegas Glyman, Mark L., MD, DDS 2030 E. Flamingo Rd. #288 89119 (702) 892-0833

Podiatry Las Vegas Anderson, Belmont W., DPM 1416 S. Jones Blvd. 89146 (702) 878-1400

Podiatry Las Vegas Bregman, Peter J., DPM/ Bregman Foot, Ankle and Nerve Center7150 W. Sunset Rd. Ste. 110 89113 (702) 703-2526

Podiatry Las Vegas Singel, Marcus J., DPM 2920 S. Rainbow Blvd. #110 89146 (702) 367-3617

Psychology Las Vegas Baumann, Janet E. PhD 501 S. Rancho Dr. F-37 89106 (702) 388-9403

Psychology Las Vegas Johnson, Don, PhD 501 S. Rancho Dr. #F-37 89106 (702) 388-9403

Psychology Las Vegas Kinsora, Thomas F., PhD 716 S. 6th St. 89101 (702) 382-1960

Psychology Las Vegas Ross, Stacy, PhD 716 S. 6th St. 89101 (702) 382-1960

Pulmonary Las Vegas Pulmonary Associates 2000 Wellness Way 89106 (702) 384-5101

Pulmonary Las Vegas Pulmonary Associates 2110 E. Flamingo Rd. #100 89119 (702) 731-9559

Pulmonary No Las Vegas Pulmonary Associates 6960 Smoke Ranch Rd. #150 89128 (702) 657-5180

Radiology (MRI) Las Vegas Advantage Diagnostic Imaging Center 3430 N. Buffalo Dr. #110 89129 (702) 362-6652

Radiology (MRI) Las Vegas Axiom Imaging of Las Vegas/ Richard Rhee 6460 Medical Center St. #150 89148 (702) 868-2781

Radiology (MRI) Las Vegas Desert Radiologists 2020 W. Palomino Ln. #100 89106 (702) 759-8606

Radiology (MRI) Henderson Desert Radiologists 2811 W. Horizon Ridge Pkwy. 89052 (702) 759-4500

This provider list is subject to change without prior notice page 6

Page 23: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Radiology (MRI) Las Vegas Desert Radiologists 3920 S. Eastern Ave. #100 89119 (702) 794-2100

Radiology (MRI) Las Vegas Desert Radiologists 7200 Cathedral Rock Dr. #230 89128 (702) 759-4300

Radiology (MRI) Las Vegas Desert Vascular Institute (Desert Rad) 3930 S. Eastern Ave. 89119 (702) 794-4384

Radiology (MRI) Las Vegas Las Vegas Radiology 3201 S. Maryland Pkwy. #102 89109 (702) 254-5004

Radiology (MRI) Las Vegas Las Vegas Radiology 401 No. Buffalo Dr. #1200 89145 (702) 254-5004

Radiology (MRI) Las Vegas Nevada Imaging Centers 5495 S. Rainbow Blvd. #101 89118 (702) 214-9729

Radiology (MRI) Henderson Nevada Imaging Centers 861 Coronado Center Dr. #101 89052 (702) 317-1200

Radiology (MRI) Las Vegas Opensided MRI (West Valley Imag) 630 S. Rancho Dr. #G 89106 (702) 932-2740

Radiology (MRI) Las Vegas Pueblo Medical Imaging (Desert Rad) 8551 W. Lake Mead Blvd. #150 89128 (702) 228-7253

Radiology (MRI) Henderson Pueblo Medical Imaging/ Parkway Imaging 100 N. Green Valley Pkwy. #130 89014 (702) 990-7419

Radiology (MRI) Las Vegas Pueblo Medical Imaging/ Radiology Associates 5495 S. Rainbow Blvd. #101 89118 (702) 477-0772

Radiology (MRI) Las Vegas Pueblo Medical Imaging/ Radiology Specialists 2628 W. Charleston Blvd. #B 89102 (702) 369-0142

Radiology (MRI) Las Vegas SimonMed Imaging/ Diag Imag So Nev 3560 E. Flamingo Rd. #100 89121 (702) 433-6100

Radiology (MRI) No Las Vegas Southern Nevada Occupational Health Ctr 4100 N. Martin Luther King Blvd #A 89032 (702) 380-1712

Radiology (MRI) Las Vegas Steinberg Diagnostic Medical Imaging 2767 N. Teneya Way 89128 (702) 732-6000

Radiology (MRI) Henderson Steinberg Diagnostic Medical Imaging 2850 Siena Heights 89052 (702) 732-6000

Radiology (MRI) Las Vegas Steinberg Diagnostic Medical Imaging 2950 S. Maryland Pkwy. 89109 (702) 732-6000

Radiology (MRI) Henderson Steinberg Diagnostic Medical Imaging 4 Sunset Way #D 89014 (702) 732-6000

Radiology (MRI) Las Vegas Steinberg Diagnostic Medical Imaging 9070 W. Post Rd. 89148 (702) 732-6000

Rehab/Occu Therapy Las Vegas Nev. Comm. Enrichment Program 6375 W. Charleston Blvd. #L-200 89146 (702) 259-1903

Rehab/Occu Therapy Las Vegas PAM Rehabilitation Hospital of Centennial Hills 6166 N. Durango Dr. 89149 (725) 233-4100

Retinology Mesquite Retina Consultants of Nevada 1301 Bertha Howe Ave. 89027 (702) 369-0200

Retinology Henderson Retina Consultants of Nevada 2845 Siena Heights Dr. #300 89052 (702) 369-0200

Retinology Las Vegas Retina Consultants of Nevada 3006 S. Maryland Pkwy. #710 89109 (702) 369-0200

Retinology Las Vegas Retina Consultants of Nevada 3006 S. Maryland Pkwy. #710 89109 (702) 369-0200

Retinology Laughlin Retina Consultants of Nevada 3650 S. Point Cir. #210 89029 (702) 369-0200

Retinology Laughlin Retina Consultants of Nevada 3650 S. Pointe Circle #210 89029 (702) 369-0200

Retinology Las Vegas Retina Consultants of Nevada 653 N.Town Center Dr #518 89144 (702) 369-0200

Retinology Henderson Retina Consultants of Nevada 710 Coronado Center Dr. 89052 (702) 369-0200

Shoulder Surgery Henderson Ashman, Edward S., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Shoulder Surgery Las Vegas Baker, Bradley, MD/ Nevada Orthopedic & Spine Center 7455 W. Washington Ave. #160 89128 (702) 258-3773

Shoulder Surgery Las Vegas Balduff, John, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Las Vegas Fontes, Roger A. MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Las Vegas Fouse, Matthew, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Shoulder Surgery Las Vegas Hanson, Chad, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Las Vegas Huff Jr., Lawrence, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Las Vegas Kastrup, John MD/ Nevada Orthopedic & Spine Center 7455 W. Washington Ave. #160 89128 (702) 878-0394

Shoulder Surgery Henderson Kim, Thomas C., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Shoulder Surgery Las Vegas Manning, James B., MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Shoulder Surgery Las Vegas Mendez, Kirk MD/ Bone and Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-0009

Shoulder Surgery Las Vegas Miao, Michael, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Shoulder Surgery Henderson Rimoldi, Reynold L., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Shoulder Surgery Las Vegas Rosen, Mark J., MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Shoulder Surgery Las Vegas Sanders, Steven, MD/ Bone & Joint Specialists 2020 Palomino Ln. #220 89106 (702) 474-7200

Shoulder Surgery Las Vegas Stewart, William T., MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Shoulder Surgery Las Vegas Song, Walter J. MD/ Nevada Ortho 7455 W. Washington Ave. #160 89128 (702) 258-3773

Shoulder Surgery Las Vegas Sutherland, Timothy B. MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Las Vegas Tingey, Craig T. MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Las Vegas Winder, Richard, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Shoulder Surgery Henderson Yu, Conrad O., MD/ Nevada Orthopedic & Spine Center 1505 Wigwam Pkwy. #330 89074 (702) 878-0393

Spine Surgery Las Vegas Anson, John A., MD/ The Spine & Brain Institute 8530 W. Sunset Rd. #250 89113 (702) 851-0792

Spine Surgery Las Vegas Bassewitz, Hugh, MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Spine Surgery Lake Havasu Cash, Andrew M., MD/ Desert Institute of Spine Care 1720 Mesquite Ave. #102 86403 (702) 630-3472

Spine Surgery Laughlin Cash, Andrew M., MD/ Desert Institute of Spine Care 3650 South Pointe Cir. #113 89029 (702) 630-3472

Spine Surgery Henderson Cash, Andrew M., MD/ Desert Institute of Spine Care 56 N. Pecos Rd. #A 89074 (702) 630-3472

Spine Surgery Las Vegas Cash, Andrew M., MD/ Desert Institute of Spine Care 600 S. Rancho Dr. #102 89107 (702) 630-3472

Spine Surgery Las Vegas Cash, Andrew M., MD/ Desert Institute of Spine Care 9339 W. Sunset Rd. 89148 (702) 630-3472

Spine Surgery Las Vegas Debiparshad, Kevin P, MC/ Synergy Spine Orthopedics 870 Seven Hills Dr. #103 89052 (702) 844-4828

Spine Surgery Laughlin Debiparshad, Kevin P, MC/ Synergy Spine Orthopedics 3650 South Pointe Cir. #101 89029 (702) 844-4828

Spine Surgery Las Vegas Douds, Gregory, MD/ Western Regional Center for Brain 3061 S. Maryland Pkwy. #200 89109 (702) 835-0088

Spine Surgery Las Vegas Dunn, Thomas, MD/ Desert Orthopedic Center 2930 W. Horizon Ridge Pkwy. #100 89052 (702) 263-9082

Spine Surgery Henderson Flangas, Gary, MD/ Las Vegas Neuro & Spine 8285 W. Arby Ave. #220 89113 (702) 737-7070

Spine Surgery Las Vegas Garber, Jason E., MD/ Las Vegas Neurosurgical 2471 Professional Ct. 89128 (702) 835-0088

Spine Surgery Las Vegas Ghuman, Babuk, MD/ Nevada Spine Clinic 7140 Smoke Ranch Rd. #240 89128 (702) 320-8111

Spine Surgery Las Vegas Grover, Jaswinder S., MD/ Nevada Spine Clinic 7140 Smoke Ranch Rd. #240 89128 (702) 320-8111

Spine Surgery Bullhead City Kabins, Mark B., MD/ LV Neurosurgery, Ortho, Rehab 2760 Silver Creek Rd. 86442 (702) 243-4700

Spine Surgery Las Vegas Kabins, Mark B., MD/ LV Neurosurgery, Ortho, Rehab 501 S. Rancho Dr. #I-67 89106 (702) 243-4700

Spine Surgery Las Vegas Kaplan, Stuart S., MD/ Las Vegas Neurosurgical 2471 Professional Ct. 89128 (702) 835-0088

Spine Surgery Las Vegas Lee, Daniel D. MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Spine Surgery Las Vegas Muir, William S., MD 653 S. Town Center Dr. #210 89144 (702) 254-3020

Spine Surgery Las Vegas OptumCare Orthopaedics and Spine Robert McBeath, MD 4750 W. Oakey Blvd. Ste. 401 89102 (702) 724-8877

Spine Surgery Henderson Peoples, Randal R., MD 2865 Sienna Heights Dr. #131 89052 (702) 737-7070

Spine Surgery Las Vegas Perry, Archie, C., MD/ Desert Orthopedic Center 2800 E. Desert Inn Rd. #100 89121 (702) 731-1616

Spine Surgery Las Vegas Rosler, Hans-Jorg W., MD/ Nevada Spine Clinic 851 S. Rampart Ste. #100 89145 (702) 320-8111

Spine Surgery Las Vegas Sharif, Kevin R. MD/ Nevada Ortho 7455 W. Washington Ave. #160 89128 (702) 258-3773

Spine Surgery Las Vegas Smith, William D., MD/ Western Regional Center For Brain 3061 S. Maryland Pkwy. #200 89109 (702) 835-0088

Spine Surgery Las Vegas Thalgott, John S., MD/ Center For Disease & Surgery Spine 600 S. Rancho Dr. #107 89106 (702) 878-8370

Spine Surgery Las Vegas Vater, Thomas, L., DO/Nevada Ortho 7455 W. Washington Ave. #160 89128 (702) 430-5000

This provider list is subject to change without prior notice page 7

Page 24: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Southern Nevada

Speciality City Name Facility Address Zip Phone

Surgery Centers Las Vegas 215 Surgery Center 6120 S. Fort Apache Rd # 200 89148 (702) 948-8894

Surgery Centers Las Vegas Allegiant Surgery Center/ Center For Spine and Special Surgery7180 Smoke Ranch Rd. #150 89128 (702) 320-8111

Surgery Centers Henderson Coronado Surgery Center 2779 W. Horizon Ridge Pkwy. #140 89052 (702) 589-9250

Surgery Centers Las Vegas Diagnostic Imaging Southern Nevada 3560 E. Flamingo Rd. #100 89121 (702) 433-6100

Surgery Centers Las Vegas Durango Outpatient Surgery Center 8530 W. Sunset Rd. #100 89113 (702) 789-5700

Surgery Centers Las Vegas Flamingo Surgery Center 2565 E. Flamingo Rd. 89121 (702) 697-7900

Surgery Centers Las Vegas Institute of Orthopaedic Surgery 2800 E. Desert Inn Rd. #150 89121 (702) 735-7355

Surgery Centers Las Vegas Las Vegas Surgery Center 870 S. Rancho Dr. 89106 (702) 870-2090

Surgery Centers Las Vegas Medical District Surgery Center 1330 S. Valley View Blvd. 89102 (702) 477-7000

Surgery Centers Henderson Parkway Surgery Center 100 Green Valley Pkwy. #125 89074 (702) 616-4954

Surgery Centers Las Vegas Sahara Surgery Center 2401 Paseo Del Prado 89102 (702) 362-7874

Surgery Centers Henderson Seven Hills Surgery Center 876 Seven Hills Dr. 89052 (702) 914-2028

Surgery Centers No Las Vegas Single Day Surgery Center 6950 W. Desert Inn Rd. #100 89086 (702) 368-6000

Surgery Centers Las Vegas Specialty Surgery Center 7250 Cathedral Rock Dr. 89128 (702) 933-3999

Surgery Centers Las Vegas Spring Valley Surgery Center 3835 S. Jones Blvd. #103 89103 (702) 227-4440

Surgery Centers Las Vegas Surgery Center of So Nevada 2110 E. Flamingo Rd. 89119 (702) 369-6784

Surgery Centers Las Vegas Surgical Arts Center 9499 W. Charleston Blvd. #250 89117 (702) 933-3600

Surgery Centers Las Vegas Tenaya Surgical Center 2800 N. Tenaya Way #101 89128 (702) 838-7755

Surgery Centers Las Vegas The Surgery Center at Tenaya/HealthSouth 2650 N. Tenaya Way #209 89128 (702) 952-3610

Trauma Las Vegas Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

Trauma Las Vegas Desert West Surgery 7200 Cathedral Rock Dr. #250 89128 (702) 383-4040

Trauma Las Vegas Iwamoto, Craig L., MD/ Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

Trauma Las Vegas Johnson, Elijah MD/ Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

Trauma Las Vegas Lewis, Terry R., MD/ Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

Trauma Las Vegas Lovett, James V., MD/ Desert West Surgery 1111 Shadow Ln. 89102 (702) 383-4040

Trauma Las Vegas Ozobia, Nathan, IBE MD/ UMC Trauma 5701 W. Charleston Blvd. Ste., #105 89146 (702) 643-0500

Urology Las Vegas Dudek, John J., MD 6970 Smoke Ranch Rd. #150 89128 (702) 382-7055

Urology Laughlin Kaplan, Michael S., MD 2645 W. Horizon Ridge Pkwy. #120 89052 (702) 454-6226

Urology Boulder City Kaplan, Michael S., MD 999 Adams Blvd. #102 89005 (702) 454-6226

Urology Las Vegas Lapinsky, Jeffrey MD/ Las Vegas Urology 7500 Smoke Ranch Rd. #200 89128 (702) 341-9000

Urology Las Vegas Las Vegas Urology 7500 Smoke Ranch Rd. #200 89128 (702) 233-0727

Urology Las Vegas Lesani, Omio A. MD/ Las Vegas Urology 7500 Smoke Ranch Rd. #200 89128 (702) 316-1616

Vascular Surgery Las Vegas Cardiovascular Consultants of Nev. 3131 La Canada St. #200 89109 (702) 731-8224

Vascular Surgery Las Vegas Donahoe, Nancy A., MD/ Cardiovscular Surgery So Nev 5320 S. Rainbow Blvd. #282 89118 (702) 737-3808

Vascular Surgery Las Vegas Khan, Zia Uddin, MD/ Desert Cardiovascular Consultants 5785 S. Fort Apache Rd., Ste.# A-100 89148 (702) 822-2273

This provider list is subject to change without prior notice page 8

Page 25: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Northern Nevada

Speciality City Name Facility Address Zip Phone

Urgent Care Carlin Carlin Community Health Center/ Nevada Health Ctrs 310 Memory Ln. 89822 (775) 754-2666

Urgent Care Carson City ARC Medical Centers 2874 N. Carson St. #135 89706 (775) 883-7855

Urgent Care Carson City MedDirect Urgent Care 1201 S. Carson St. 89701 (775) 445-7330

Urgent Care Carson City Nevada Occupational Health 3488 Goni Rd. Bldg E#141 89706 (775) 887-5030

Urgent Care Carson City Sierra Family Health Center (M-F 7-5, Sat 8-5) 907 Mountain St. #2 89703 (775) 887-5140

Urgent Care Elko Elko Family Health Ctrs/ Nevada Health Ctrs 762 14th St. 89801 (775) 738-5850

Urgent Care Elko The Elko Clinic 1995 Errecart Blvd. #102 89801 (775) 738-3111

Urgent Care Fernley Fernley Urgent Care (M-F 9-7, Sat 9-3) 1343 W. Newlands Dr. 89408 (775) 575-3600

Urgent Care Fernley Renown Urgent Care (M-F 9-7, Sat 9-3) 1343 W. Newlands Dr. 89408 (775) 982-6522

Urgent Care Gardnerville Carson Valley Occu Health (M-F 7:30-4) 1107 Hwy. 395 North 89410 (775) 782-1500

Urgent Care Incline village Heilman, Timothy, MD/ Incline Village Urgent Care 930 Tahoe Blvd. #207 89451 (775) 833-2929

Urgent Care Incline Village Incline Village Medical Clinic 880 Alder Ave. 89451 (775) 833-4100

Urgent Care Jackpot Jackpot Community Health Center 950 Lady Luck Dr., 89825 (775) 755-2500

Urgent Care Minden Minden Medical Emergency-Urgent Care 925 Ironwood Dr. #1104 89423 (775) 783-7800

Urgent Care Reno Concentra Medical Centers 6410 S. Virgina Rd., 89511 (775) 322-5757

Urgent Care Reno Renown Health Urgent Care (M-F 9-7) 10085 Double 'R' Blvd. #120 89511 (775) 982-4590

Urgent Care Reno Renown Occupational Health (M-F 8-5) 975 Ryland St. 89502 (775) 982-4754

Urgent Care Reno Renown Urgent Care 1075 North Hills Blvd. #170 89506 (775) 982-6546

Urgent Care Reno Renown Urgent Care (M-F 9-8, S-S 9-6) 975 Ryland St. 89502 (775) 982-4554

Urgent Care Reno Renown/ Keystone Urgent Care (M-F 8-5) 4791 Summit Ridge Dr. 89523 (775) 982-5000

Urgent Care Reno Saint Mary's Galena Urgent Care 18653 Wedge Pkwy. #300 89511 (775) 770-7209

Urgent Care Reno South Meadows Urgent Care (M-F 9-7) 10085 Double 'R' Blvd. #120 89511 (775) 982-8185

Urgent Care Reno South Virginia Medical Center 6580 S. Virginia St. 89511 (775) 853-9959

Urgent Care S. Lake Tahoe Barton/ Tahoe Carson Valley Medical Group 1090 3rd. St., 96150 (530) 542-3000

Urgent Care Sparks ARC Medical Centers 2205 E. Glendale Ave. #131 89431 (775) 331-3361

Urgent Care Sparks Concentra Medical Centers 255 Glendale Ave. #12 89431 (775) 356-8181

Urgent Care Sparks Renown Sparks Urgent Care 910 Vista Blvd. 89434 (775) 982-6769

Urgent Care Sparks Renown Urgent Care (M-F 8-7:30, S-S 8-4:30) 202 Los Altos Pkwy. 89436 (775) 982-6228

Urgent Care Sparks St Mary's Uirgent Care/ Primary Care Plus 5070 Ion Dr. #100 89436 (775) 354-0200

Urgent Care Stead Renown North/Stead Urgent Care 1075 North Hills Blvd. #180 89506 (775) 982-6546

Urgent Care Wellington Topaz Ranch Medical Clinic 3919 Carter Dr. 89444 (775) 783-3096

Urgent Care West Wendover Wendover Comm Health/ Nevada Health Ctrs 925 Wells Ave. 89883 (775) 664-2220

Hospital Carson City Carson Tahoe Regional Medical Center 1600 Medical Pkwy. 89703 (775) 445-8000

Hospital Elko Northeastern Nevada Reg. Hospital 2001 Errecart Blvd. 89801 (775) 738-5151

Hospital Ely William Bee Ririe Hospital 1500 Avenue 'H' 89301 (775) 289-3001

Hospital Fallon Banner Churchill Community Hospital 801 E. Williams St. 89406 (775) 423-3151

Hospital Gardnerville Carson Valley Medical Center 1107 Hwy. 395 North 89410 (775) 782-1500

Hospital Incline Village Incline Village Community Hospital 10121 Pine Ave. 96160 (775) 587-6011

Hospital Lovelock Pershing General Hospital 855 6th St. 89419 (775) 273-2621

Hospital Reno Renown Regional Medical Center 1155 Mill St. 89502 (775) 982-4100

Hospital Reno Renown South Meadows Medical Center 10101 Double 'R' Blvd. 89521 (775) 982-7000

Hospital Reno Saint Mary's Regional Med Center/ Prime 235 W. 6th St. 89503 (775) 770-3000

Hospital S. Lake Tahoe Barton Memorial Hospital 2170 South Ave. 96150 (530) 541-3420

Hospital Sparks Northern Nevada Medical Center 2375 E. Prater Way 89434 (775) 331-7000

Hospital Winnemucca Humboldt General Hospital 118 E. Haskell St. 89445 (775) 623-5222

Hospital Yerington South Lyon Medical Center 213 So. Whitacre 87447 (775) 463-2301

Hospital-Rehab Carson City Carson Rehabilitation Center 1600 Medical Pkwy. 89703 (775) 445-8000

Hospital-Rehab Carson City Sierra Surgery Hospital 1400 Medical Pkwy. 89703 (775) 883-1700

Hospital-Rehab Reno Renown Rehabilitation Hospital 1495 Mill St. 89502 (775) 982-3500

Hospital-Rehab Reno Tahoe-Pacific Hospital 10101 Double 'R' Blvd. 89521 (775) 331-1044

Hospital-Rehab Reno Tahoe-Pacific Hospital 235 W. 6th St. 89503 (775) 355-5970

Acupuncture Reno The Finley Center/ Finley, Tara, OMD 6490 W. McCarran Blvd. #F52 89509 (775) 337-1334

Anesthesiology Carson City Goode, Randall MD 973 Mica Dr. #200 89705 (775) 455-7225

Anesthesiology Carson City Northern Nevada Anesthesia Assoc 1894 E. William St. #4-502 89701 (877) 432-5038

Anesthesiology Reno Associated Anesthesiologists 1 E. Libery St. #555 89501 (775) 348-1900

Anesthesiology Reno Sierra Anesthesia 520 Hammill Ln. 89511 (775) 786-9666

Audiology Carson City Campbell, Nanci AuD 844 W. Nye Ln. #203 89703 (775) 883-4764

Audiology Carson City Carson Tahoe Therapy 1122 So. Stewart 89701 (775) 885-6686

Audiology Carson City Weeks, Mark, AUD/ Hearing Care of Carson 408 N. Roop St. 89701 (775) 885-9888

Audiology Dayton Carson Tahoe Therapy 901 Medical Center Dr. #200 89403 (775) 246-2021

Audiology Gardnerville Carson Tahoe Therapy 1122 So. Stewart 89701 (775) 885-6686

Audiology Minden Carson Tahoe Therapy 925 Ironwood Dr. #109 89423 (775) 783-7842

Audiology Reno Reno Hearing Center 1855 Plumas St. #5 89509 (775) 825-6006

Cardiology Carson City Sierra Nev. Cardiology Associates 3641 G's Richards Blvd. #203 89703 (775) 982-2400

Cardiology Fallon Sierra Nev. Cardiology Associates 1077 New River Pkwy. 89406 (775) 428-2747

Cardiology Gardnerville Sierra Nev. Cardiology Associates 1107 Hwy. 395 North 89410 (775) 782-1530

Cardiology Hawthorne Sierra Nev. Cardiology Associates 150 South 'C' St. 89415 (775) 945-0751

Cardiology Reno Field, Anthony MD 1500 E. 2nd St. #400 89502 (775) 885-9886

Cardiology Reno Sierra Nev. Cardiology Associates 10085 Double 'R' Blvd. #365 89502 (775) 785-5220

Cardiology Sparks Sierra Nev. Cardiology Associates 2385 E. Prater Way #200 89434 (775) 784-9324

Chiropractic Carson City Bray, William, DC 201 W. Adams St. 89703 (775) 883-7200

Chiropractic Carson City Cassity, Annette, DC 120 E. John St. 89706 (775) 884-9355

Chiropractic Carson City Fischer, Paul, DC 805 N. Division St. 89703 (775) 882-5800

Chiropractic Carson City Mitchell, Darren, DC/ Active Chiro 120 E. John St. 89706 (775) 885-7555

This provider list is subject to change without prior notice page 1

Page 26: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Northern Nevada

Speciality City Name Facility Address Zip Phone

Chiropractic Elko Sherwood, John, DC 2219 N. 5th St. #B 89801 (775) 738-2225

Chiropractic Elko Taylor, Wade, DC 1810 Pinon Rd. 89801 (775) 753-7387

Chiropractic Fernley David Kahn, DC/ Friendly Chiro 240 Hwy 95A #B 89408 (775) 575-5511

Chiropractic Gardnerville Trujillo, David, DC 1532 Hwy 395 N #3 89410 (775) 782-2910

Chiropractic Incline village Incline Chiropractic 894 Southwood Blvd., 89451 (775) 831-5544

Chiropractic Reno Nolle, Jack, DC 6630 S. McCarran Blvd. #A2 89509 (775) 829-1778

Chiropractic Reno Olsen, Shauna L., DC 1699 S. Virginia St. #100 89502 (775) 826-5575

Chiropractic Reno Pirruccello, Paul, DC/ Sierra Chiropractic LLC 3670 Grant Dr. #101 89509 (775) 852-3333

Chiropractic Reno Riley, Nicholas V., DC/ Northern Nevada Chiropractic 5301 Longley Ln. #B43 89511 (775) 829-8686

Chiropractic Sparks Scherschel, John, DC/ B Street Chiro 316 Victoria Ave. 89431 (775) 359-6500

Chiropractic Winnemucca Verner, Dennis, DC 504 E. 2nd St. 89445 (775) 623-3938

Chiropractic Yerington Scherschel, John, DC/ Yerington Chiro Ctr 14 North Hwy. 95 #A 89447 (775) 463-7766

Dental Reno Martinez, David O., DDS 257 Brinkby Ave. 89509 (775) 827-9400

Dental Reno McMullen, Joseph R., DDS, MD 290 Brinkby Ave. 89509 (775) 825-0285

Dental Reno Pendleton, Bruce, DDS 525 Hammill Ln. 89511 (775) 825-2227

Dental Reno Pisani, Gregory, DDS 548 W. Plumb Ln. #A 89509 (775) 329-9534

Dental Reno Stasiewicz, Carl, DDS 300 Brinkby Ave. 89509 (775) 829-8222

Dental Sparks Webber, Dean, DDS 4650 Wedekind Rd. #1 89431 (775) 356-8254

Dermatology Carson City Carson Dermatology 1505 Medical Pkwy 89701 (775) 883-7811

Durable Med Equip Carson City Hanger Prosthetics & Orthotics West 403 W. Nye Ln. #D 89706 (775) 882-2232

Durable Med Equip Carson City Home Care Plus 2874 N. Carson St. #130 89706 (775) 687-1530

Durable Med Equip Carson City OrthoPro of Carson City, Inc. 415 W. Sophia #200 89703 (775) 841-0660

Durable Med Equip Carson City RAM Durable Medical Equipment/ SCORE 7909 Silverton Ave. #214 92126 (858) 549-1771

Durable Med Equip Elko OrthoPro of Elko 997 Court St 89801 (775) 778-0507

Durable Med Equip Las Vegas IPS

Durable Med Equip Reno Acadian Rehab Inc 175 S. Park St. 89502 (775) 333-6600

Durable Med Equip Reno Bennett Medical Services 2600 Mill St. #600 89502 (775) 329-0799

Durable Med Equip Reno DJ Ortho

Durable Med Equip Reno EMPI

Durable Med Equip Reno Hanger Prosthetics & Orthotics West 961 Matley Lane #100 89502 (775) 323-8118

Durable Med Equip Reno Home Care Plus 1201 Corporate Blvd. #130 89502 (775) 828-1000

Durable Med Equip Reno Oprion Care/ Arlington Clinical Infusion 7300 So. Virginia St. #A 89511 (775) 828-8200

Durable Med Equip Reno OrthoPro of Reno, Inc. 487 Casazza Dr. 89502 (775) 324-1443

Durable Med Equip Reno Pacific Medical, Inc. 961 Matley Lane #160 89502 (775) 324-2394

Durable Med Equip Sparks KCI 1360 Greg St. 89431 (775) 331-8297

Durable Med Equip Sparks Vital Care 1360 Greg St. #104 89431 (775) 884-4040

Ear, Nose & Throat Carson City Forest, John, MD/ Sierra Nev ENT 2874 N. Carson St. #220 89706 (775) 883-7666

Ear, Nose & Throat Carson City Manoukian, Paul, MD/ Sierra Nev ENT 2874 N. Carson St. #220 89706 (775) 883-7666

Ear, Nose & Throat Carson City Romaneschi, Brian, MD/ Sierra Nev ENT 2874 N. Carson St. #220 89706 (775) 883-7666

Ear, Nose & Throat Carson City Sierra Nevada ENT 2874 N. Carson St. #220 89706 (775) 883-7666

Ear, Nose & Throat Fallon Sierra Nevada ENT 801 E. Williams Ave. 89406 (775) 883-7666

Ear, Nose & Throat Gardnerville Sierra Nevada ENT 1520 Virginia Ranch Rd. #103 89410 (775) 782-3888

Ear, Nose & Throat Reno Ludlow, Paul C., MD 645 N. Arlington Ave. #670 89503 (775) 324-3800

Ear, Nose & Throat Reno West, Bud, MD 900 Ryland St., 89502 (775) 323-2157

Ear, Nose & Throat Winnemucca Elko ENT Specialists 900 Ryland St., 89502 (775) 323-2488

Gastroenterology Carson City Gastroenterology Consultants 707 N. Minnesota St. 89703 (775) 884-4567

General Surgery Carson City Bessette, Richard, MD 1525 Vista Ln. #100 89703 (775) 887-8885

General Surgery Carson City Carson Surgical Group 1375 Vista Ln. 89703 (775) 882-2067

General Surgery Carson City Halow, Kevin, MD/ Carson Surg Group 1375 Vista Ln. 89703 (775) 882-2067

General Surgery Carson City King, Timothy, MD/ Carson Surg Group 1375 Vista Ln. 89703 (775) 882-2067

General Surgery Elko The Elko Clinic 1995 Errecart Blvd. #102 89801 (775) 738-3111

General Surgery Minden Carson Surgical Group 1702 County Rd. #A-4 89423 (775) 782-5594

General Surgery Reno Nachtsheim, Robert J.MD/ Reno Surgical Assoc 1500 E. 2nd St. #206 89502 (775) 789-7050

General Surgery Reno Ramos, Susan R., MD 223 Marsh Ave., 89509 (775) 323-8050

General Surgery Reno Reno Surgical Assoc/ General and Vascular Assoc 1500 E. 2nd St. #206 89502 (775) 789-7050

General Surgery Reno Stumpf, Paul, MD/ Reno Surgical Assoc 1500 E. 2nd St. #206 89502 (775) 789-7050

General Surgery Reno Watson, John, DO 75 Pringle Way #606 89502 (775) 323-0505

General Surgery Reno Western Surgical Group 75 Pringle Way #1002 89502 (775) 323-7500

Hand Surgery Carson City Gabriel, Kent W., MD 704 West Nye Lane # 102 89703 (775) 885-8890

Hand Surgery Reno Babovic, Nikola MD/ Reno Orthopaedic 555 N. Arlington Ave. 89503 (775) 786-3040

Hand Surgery Reno Cepela, Daniel MD/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Hand Surgery Reno Christensen, James MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Hand Surgery Reno Christensen, Thomas MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 756-3040

Hand Surgery Reno Dahan, Philip E., MD 10755 Double 'R' Blvd. 89521 (775) 826-4477

Hand Surgery Reno Fitzpatrick, Elizabeth MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Hand Surgery Reno Huene, Donald S., MD/ Ortho Surg Assoc 85 Kirman Ave. #303 89502 (775) 329-8423

Hand Surgery Reno Kaiser, Kirk, MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Hand Surgery Reno Kiener, Joseph L., MD 530 Hammill Ln. 89511 (775) 825-1234

Hand Surgery Reno McCormack, Tiffany, MD/ McCormack Plastic Surgery 10791 Double 'R' Blvd. 89521 (775) 284-2020

Hand Surgery Reno Murphy Plastic Surgery 10401 Double 'R' Blvd. 89502 (775) 322-3446

Hand Surgery Reno Murphy, James E., MD/ Murphy Plastic Surg 10401 Double 'R' Blvd. 89521 (775) 322-3446

Hand Surgery Reno Weldin, Elizabeth MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Home Health Care Reno Gentiva Rehab Without Walls 4900 Mill St. #1 89502 (775) 858-1912

Home Health Care Reno Renown Health Home Care 3935 S. McCarran Blvd. 89502 (775) 982-5860

This provider list is subject to change without prior notice page 2

Page 27: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Northern Nevada

Speciality City Name Facility Address Zip Phone

Home Health Care Reno Saint Mary's Home Health 690 Sierra Rose Dr. 89511 (775) 770-3046

Home Health Care Sparks Renown Skilled Nursing 1835 Oddie Blvd. 89431 (775) 982-5140

Internal Medicine Carson City Lake Tahoe Regional Hospitalists 1600 Medical Pkwy. 89703 (775) 445-8000

Internal Medicine Elko Hogle, David, MD 1995 Errecart Blvd. #102 89801 (775) 738-3111

Internal Medicine Fallon Ridenour, Gary C., MD 625 W. Williams Ave. #B 89407 (775) 423-6400

Internal Medicine Reno Watson, John, MD/ Renown Health 75 Pringle Way #1002 89502 (777) 982-5000

Internal Medicine Reno Young, Bryan MD/ Renown Health 6570 S. McCarran Blvd., 89509 (775) 982-6130

Neurology Carson City Lagios, John, MD 1001 N. Mountain St. #3B 89703 (775) 885-9400

Neurology Carson City Sierra Neurosurgery Group 5590 Kitzke Ln. 89511 (775) 323-2080

Neurology Reno Bacchus, Malcolm D., MD/ Reno Neurology 6630 S. McCarran Blvd. #8 89509 (775) 824-8100

Neurology Reno Bigley, G. Kim, MD 75 Pringle Way #910 89502 (775) 324-2234

Neurology Reno Hershewe, Gerard L, DO 75 Pringle Way # 605 89502 (775) 329-4500

Neurology Reno Louie, Timothy, MD 645 N. Arlington Ave. #655 89503 (775) 770-7664

Neurology Reno Quaglieri, Frank C., MD/ Reno Neurology 6630 S. McCarran Blvd. #8 89509 (775) 824-8100

Neurology Reno Reno Neurological Associates 6630 S. McCarran Blvd. #8 89509 (775) 824-8100

Neurosurgery Carson City Sierra Neurosurgery Group 844 W. Nye Ln. #102 89703 (775) 323-2080

Neurosurgery Carson City Song, Michael, MD/ Advanced Neurosurgery 1470 Medical Pkwy. #202 89703 (775) 323-6100

Neurosurgery Reno Davis, John, MD/ Sierra Neurosurgery 5590 Kitzke Ln. 89511 (775) 323-2080

Neurosurgery Reno Fleming, Hilary, MD/ Sierra Neurosurgery 5590 Kitzke Ln. 89511 (775) 323-2080

Neurosurgery Reno Lynch James J., MD/ Spine Nevada 9990 Double 'R' Blvd. #200 89521 (775) 348-8800

Neurosurgery Reno Morgan, Jay, MD/ Sierra Neurosurgery 5590 Kitzke Ln. 89511 (775) 323-2080

Neurosurgery Reno Sekhon, Lali H., MD PhD/ Sierra Neurosurgery 75 Pringle Way #1007 89502 (775) 657-8844

Neurosurgery Reno Sierra Neurosurgery Group 5590 Kitzke Ln. 89511 (775) 323-2080

Neurosurgery Reno Song, Michael, MD/ Advanced Neurosurgery 10509 Professional Cir. #101 89521 (775) 323-6100

Neurosurgery Reno Vacca, Dante, MD/ Sierra Neurosurgery 5590 Kitzke Ln. 89511 (775) 323-2080

Neurosurgery Sparks Lynch James J., MD/ Spine Nevada 780 Vista Blvd. #100 89434 (775) 348-8800

Ophthalmology Carson City Center for Advanced Eye Care 1104 N. Division St. 89703 (775) 882-9123

Ophthalmology Carson City Vazeen, Mehdi, MD/ Ctr for Adv. Eye Care 1104 N. Division St. 89703 (775) 882-9123

Ophthalmology Carson City Wu, Zigiang, MD/ Ctr for Advanced Eye Care 1104 N. Division St. 89703 (775) 882-9123

Ophthalmology Elko Houchin, Kenneth, MD 875 14th St. 89801 (775) 738-5193

Ophthalmology Reno Cohen, Gregory, MD/ Sierra Eye Assoc 950 Ryland St. 89502 (775) 329-0286

Ophthalmology Reno Durant, William, MD/ Sierra Eye Assoc 950 Ryland St. 89502 (775) 329-0286

Ophthalmology Reno Hearne, Isaac, MD/ Laser and Cataract Ctr 294 E. Moana Ln. #22 89502 (775) 827-8855

Ophthalmology Reno Sierra Eye Associates 950 Ryland St. 89502 (775) 329-0286

Ophthalmology Reno Sierra Nevada Eye Center 9468 Double 'R' Blvd. #B 89521 (775) 322-3333

Ophthalmology Reno Stanko, Michael, MD/ Sierra Eye Assoc 950 Ryland St. 89502 (775) 329-0286

Ophthalmology Reno Vazeen, Micahel, MD/ Sierra Eye Assoc 950 Ryland St. 89502 (775) 329-0286

Ophthalmology Reno Wolff, Robert, MD/ Sierra Nevada Eye Center 9468 Double 'R' Blvd. #B 89521 (775) 322-3333

Ophthalmology/Retinology Carson City Center for Advanced Eye Care 1104 N. Division St. 89703 (775) 882-9123

Ophthalmology/Retinology Gardnerville Center for Advanced Eye Care 1516 Virginia Ranch Rd. #2A 89410 (775) 783-4823

Ophthalmology/Retinology Reno Friedlander, Steve MD/ Nevada Retina Assoc 610 Sierra Rose Dr. 89511 (775) 356-7272

Orthopedics Carson City Anderson, Martin MD 974 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Bannar, Stephen MD 974 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Dirig, Nicholas DO/ Tahoe Fracture 973 Mica Dr. #201 89705 (775) 392-3680

Orthopedics Carson City Dyer, Jeromy 977 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Edmunds, Michael MD 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Eisenhauer, David DO 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Fry, III Paul MD 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Fry, Michael 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Garcia, Autumn 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Garza, Damian 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Jones, David MD 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Lake Tahoe Orthopaedic Institute 935 Mica Dr. Ste. #15 89703 (775) 884-3131

Orthopedics Carson City Orr Terrence MD/ Tahoe Orthopedics & Sports 935 Mica Dr. Ste. #15 89705 (775) 783-3065

Orthopedics Carson City Ries, Michael MD 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Robertson, Daniel MD/ Lake Tahoe Ortho 935 Mica Dr. Ste. #15 89703 (775) 884-3131

Orthopedics Carson City Rogalski, Roger, MD/ Tahoe Fracture & Ortho 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Shapiro, Michael, MD/ Tahoe Fracture & Ortho 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Swanson, Keith MD/ Lake Tahoe Ortho 935 Mica Dr. Ste. #15 89703 (775) 884-3131

Orthopedics Carson City Tahoe Fracture & Ortho Med Clinic 2874 N. Carson St. #105 89706 (775) 841-9991

Orthopedics Carson City Tahoe Fracture & Ortho Med Clinic 973 Mica Dr. #201 89705 (775) 783-6190

Orthopedics Carson City Walls, Joseph, MD 973 Mica Dr. #201 89705 (775) 888-9197

Orthopedics Fallon Reno Orthopaedic Clinic 195 N. Ada 89406 (775) 423-7011

Orthopedics Gardnerville Southard, Scott W., MD 1520 Virginia Ranch Rd. #1B 89140 (530) 541-4117

Orthopedics Gardnerville Tahoe Orthopaedic and Sports Medicine 1520 Virginia Ranch Rd. #101B 89410 (775) 782-2442

Orthopedics Hawthorne Tahoe Fracture & Ortho Med Clinic 150 South 'C' St. 89415 (775) 945-0751

Orthopedics Incline village Ganong, Alison MD 926 Tahoe Blvd. #105 89451 (775) 783-6191

Orthopedics Minden Davis, Jack, DO 925 Ironwook Dr. #1108 89423 (775) 888-9197

Orthopedics Minden Walls, Joseph, MD 925 Ironwook Dr. #1108 89423 (775) 888-9197

Orthopedics Reno Advanced Orthopedics 689 Sierra Rose Dr. #B 89511 (775) 786-2100

Orthopedics Reno Arraiz, Martin Jose MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 756-3040

Orthopedics Reno Berkich, Garret 556 N. Arlington Ave. 89503 (775) 786-3041

Orthopedics Reno Bjerke, Benjamin MD 557 N. Arlington Ave. 89503 (775) 786-3042

Orthopedics Reno Bodemer, William, MD/ Great Basin Ortho 845 Aitken St. 89502 (775) 786-1444

This provider list is subject to change without prior notice page 3

Page 28: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Northern Nevada

Speciality City Name Facility Address Zip Phone

Orthopedics Reno Boyden, Eric, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics Reno Bray, Timothy, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics Reno Cassinelli, Spenser MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Orthopedics Reno Christensen, James, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics Reno Cummings, Jeffrey R. MD/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Orthopedics Reno Davis, Richard V., MD/ Orthopaedic Assoc 75 Pringle Way #912 89502 (775) 786-3380

Orthopedics Reno Daws, Snow MD 560 N. Arlington Ave. 89503 (775) 786-3045

Orthopedics Reno Diefenback, Christopher MD 560 N. Arlington Ave. 89503 (775) 786-3045

Orthopedics Reno Dirig, Nicholas DO/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Orthopedics Reno Dobbs, Ryan, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics Reno Dow, Stephen D., MD/ Orthopedic Surg Assoc 85 Kirman Ave #303 89502 (775) 329-8423

Orthopedics Reno Dunaway, Linda 559 N. Arlington Ave. 89503 (775) 786-3044

Orthopedics Reno Edmunds, Michael MD/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Orthopedics Reno Flint, Suzanne 562 N. Arlington Ave. 89503 (775) 786-3047

Orthopedics Reno Fyda, Thomas MD/ Great Basin Ortho 845 Aitken St. 89502 (775) 786-1444

Orthopedics Reno Gallion, Brace 563 N. Arlington Ave. 89503 (775) 786-3048

Orthopedics Reno Gray, William J., MD/ Advanced Ortho 689 Sierra Rose Dr. #B 89511 (775) 786-2100

Orthopedics Reno Hayes, Richard MD/ Great Basin Ortho 845 Aitken St. 89502 (775) 786-1444

Orthopedics Reno Jackson, Jr. Lyle MD 564 N. Arlington Ave. 89503 (775) 786-3049

Orthopedics Reno Janas, Allie 565 N. Arlington Ave. 89503 (775) 786-3050

Orthopedics Reno Jones, Jackson MD 566 N. Arlington Ave. 89503 (775) 786-3051

Orthopedics Reno Kaiser, Kirk, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics Reno Kip, Phelps, MD/ Sierra Regional Spine 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Orthopedics Reno Malcarney, Hilary L., MD/ Nevada Orthopedics 10635 Professional Cir. #A 89521 (775) 852-0506

Orthopedics Reno Mast, Nicholas MD/ Advanced Ortho 689 Sierra Rose Dr. #B 89511 (775) 786-2100

Orthopedics Reno Matteoni, Kenneth, MD/ Advanced Ortho 689 Sierra Rose Dr. #B 89511 (775) 786-2100

Orthopedics Reno Miller, Glenn G., MD 1895 Plumas St. #6 89509 (775) 852-7773

Orthopedics Reno Mullins, Richard MD/ Great Basin Ortho 9480 Double Diamond Pkwy. 89521 (775) 785-1600

Orthopedics Reno Nevada Orthopaedics 10635 Professional Cir. #A 89521 (775) 852-0505

Orthopedics Reno Nicolet, Nate 568 N. Arlington Ave. 89503 (775) 786-3053

Orthopedics Reno Olson, James H. ,MD/ Sierra Regional Spine 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Orthopedics Reno Orthopaedic Associates, LLP 75 Pringle Way #912 89502 (775) 786-3380

Orthopedics Reno Orthopedic Surgical Associates 85 Kirman Ave #303 89502 (775) 329-8423

Orthopedics Reno Preston, Digby M, MD/ Orthopaedic Assoc 75 Pringle Way #912 89502 (775) 786-3380

Orthopedics Reno Prutzman, George W., MD/ Advanced Ortho 689 Sierra Rose Dr. #B 89511 (775) 786-2100

Orthopedics Reno Rappaport, James R., MD/ Sierra Regional Spine 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Orthopedics Reno Reno Orthopaedic Clinic 350 W. Sixth St., 2nd floor 89503 (775) 786-3040

Orthopedics Reno Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Orthopedics Reno Shahard, Paul, MD/ Nevada Orthopedics 10635 Professional Cir. #A 89521 (775) 852-0505

Orthopedics Reno Sierra Regional Spine Institute 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Orthopedics Reno Smith, Basil E., MD/ Orthopedic Surg Assoc 85 Kirman Ave #303 89502 (775) 329-8423

Orthopedics Reno Sobiek, James S., MD/ Orthopedic Surg Assoc 85 Kirman Ave #303 89502 (775) 329-8423

Orthopedics Reno Uppal, Renny, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics Reno Webster, Jeffrey D,. MD/ Orthopaedic Assoc 75 Pringle Way #912 89502 (775) 786-3380

Orthopedics Reno Zebrack, John, MD/ Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89503 (775) 786-3040

Orthopedics S. Lake Tahoe Tahoe Fracture & Ortho Med Clinic 1139 3rd St. 96150 (530) 541-3100

Orthopedics Sparks Reno Orthopaedic Clinic 5070 Ion Dr. 89436 (775) 786-3040

Orthopedics Winnemucca Davis, Richard MD/ Orthopedic Assoc. 118 E. Haskell St. # B 89445 (775) 786-3040

Orthopedics Winnemucca Kroner, III Ludwig MD/ Orthopedic Assoc. 118 E. Haskell St. # B 89445 (775) 786-3040

Orthopedics Winnemucca Langevin, James MD/ Orthopedic Assoc. 118 E. Haskell St. # B 89445 (775) 786-3040

Orthopedics Winnemucca Mull, Sears MD/ Orthopedic Assoc. 118 E. Haskell St. # B 89445 (775) 786-3040

Orthopedics Winnemucca Osgood, Patrick MD/ Orthopedic Assoc. 118 E. Haskell St. # B 89445 (775) 786-3040

Orthopedics Winnemucca Othopaedic Assoc. 118 E. Haskell St. # B 89445 (775) 786-3040

Orthopedics Yerington S. Lyon Medical Center/ Tahoe Fracture & Ortho 213 So. Whitacre 89447 (775) 781-3761

Orthopedics Zephyr Cove Robertson, Daniel MD/ Lake Tahoe Ortho 212 Elks Point Rd. #200 89448 (775) 588-3636

Orthopedics Zephyr Cove Swanson, Keith MD/ Lake Tahoe Ortho 212 Elks Point Rd. #200 89448 (775) 588-3636

Pain Management Carson City Goode, Randall MD/ Carson Douglas Pain 973 Mica Dr. #102 89705 (775) 445-7225

Pain Management Carson City Mullen, Bruce, MD/ Spine Care and Rehab 755 N. Roop St. #112 89706 (775) 883-7938

Pain Management Carson City Sullivan, James MD/ Tahoe Fracture 973 Mica Dr. #201 89705 (775) 392-3680

Pain Management Reno Associated Anesthesiologists of Reno 1 E. Libery St. #555 89501 (775) 348-1900

Pain Management Reno Berman, Steven, MD 605 Sierra Rose Dr. #4 89511 (775) 689-5410

Pain Management Reno Berry, Robert, MD/ Ortho Rehab Specialists 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Pain Management Reno Sullivan, James MD/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Pain Management Reno Twombly, Christopher, MD/ Ortho Rehab Specialists 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Pain Management Reno Wesely, Andrew, MD 605 Sierra Rose Dr. #4 89511 (775) 689-5410

Pathology/Lab Carson City Carson Tahoe Pathology 1600 Medical Pkwy. 89703 (775) 445-8514

Pathology/Lab Carson City Lab Corporation of America 604 W. Washington St. #D 89703 (775) 885-6777

Pathology/Lab Incline Village Lab Corporation of America 926 Incline Way #105 89451 (775) 832-1013

Pathology/Lab Minden Lab Corporation of America 1760 Hwy. 395 #L 89423 (775) 782-4532

Pathology/Lab Reno Lab Corporation of America 15 McCabe Dr. #C 89511 (775) 850-3611

Pathology/Lab Reno Lab Corporation of America 2005 Silverada Blvd. #120 89512 (775) 352-1500

Pathology/Lab Reno Lab Corporation of America 601 Ralston St. 89503 (775) 334-3491

Pathology/Lab Reno Lab Corporation of America 601 Sierra Rose Dr. #103 89511 (775) 827-7950

Pathology/Lab Reno Lab Corporation of America 7111 S. Virginia St. #A20 89511 (775) 851-3900

This provider list is subject to change without prior notice page 4

Page 29: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Northern Nevada

Speciality City Name Facility Address Zip Phone

Pathology/Lab Reno Lab Corporation of America 890 Mill St. #105 89502 (775) 334-3562

Pathology/Lab Reno Sierra Pathology Associates, Inc. 475 Kirman Ave. 89502 (775) 334-3450

Pathology/Lab Reno Western Pathology Consultants 343 Elm St. #206 89503 (775) 746-3400

Pathology/Lab Sparks Lab Corporation of America 1335 Baring Blvd. 89434 (775) 352-1509

Physical Medicine Carson City Costa, Peter, MD 973 Mica Dr. #201 89705 (775) 783-6190

Physical Medicine Carson City Mullen, Bruce, MD/ Spine Care and Rehab 755 N. Roop St. #112 89701 (775) 883-7938

Physical Medicine Carson City Wichener, Monica, MD 1495 Mill St. #100 89502 (775) 881-7115

Physical Medicine Elko Geisler, Andrew MD/ Elko Spine and Rehab 2219 N. 5th St. 89801 (775) 777-9669

Physical Medicine Gardnerville Costa, Peter, MD 1520 Virginia Ranch Rd. #101B 89410 (775) 782-2442

Physical Medicine Incline Village Salas, Michael M., MD/ Tahoe Spine Center 10085 Double R Blvd. #205 89521 (775) 982-5000

Physical Medicine Reno Berry, Robert, MD/ Ortho Rehab Specialists 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Physical Medicine Reno Mars, George, MD 645 Sierra Rose Dr. #202 89511 (775) 825-9990

Physical Medicine Reno Miles, Kevin, DO/ Aspen Spine and Pain 890 Mill St. #102 89502 (775) 324-6300

Physical Medicine Reno Orthopedic Rehab Specialists 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Physical Medicine Reno Reyher, John L. DO/ Ortho Rehab Specialists 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Physical Medicine Reno Spine Nevada 9990 Double 'R' Blvd. #200 89521 (775) 348-8800

Physical Medicine Reno Tomita, Robin MD/ Tahoe Fracture 973 Mica Dr. #201 89705 (775) 392-3680

Physical Medicine Reno Twombly, Christopher, MD/ Ortho Rehab Specialists 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Physical Medicine Sparks Bantum, Brian MD/ Silver State Spine Care 1055 Roberta Ln. #103 89431 (775) 331-2600

Physical Medicine Sparks Burke, Forrest B., MD/Silver State Spine Care 1055 Roberta Ln. #103 89431 (775) 331-2600

Physical Medicine Sparks Silver State Spine Care 1055 Roberta Ln. #103 89431 (775) 331-2600

Physical Medicine Sparks Spine Nevada 780 Vista Blvd. #100 89434 (775) 348-8800

Physical Medicine Sparks Tatro, Andrea M., M.D./Silver State Spine Care 1055 Roberta Ln. #103 89431 (775) 331-2600

Physical Therapy Carson City Ascent Physical Therapy 2350 S. Carson St. #3 89706 (775) 885-9965

Physical Therapy Carson City Carson Physical Therapy 680 W. Nye Ln. #205 89703 (775) 882-2211

Physical Therapy Carson City High Desert Therapists 2874. N Carson St. #100 89706 (775) 883-4161

Physical Therapy Carson City Sports Therapy & Rehabilitation 303 Fleshmann Way 89703 (775) 885-7827

Physical Therapy Dayton High Desert Therapists 5 PineCone Rd. 89403 (775) 296-7742

Physical Therapy Elko Elko Spine and Rehabilitation Inst. 2219 N. 5th St. 89801 (775) 777-9669

Physical Therapy Elko Full Range Physical Therapy 620 So. 12th St. #110 89801 (775) 738-0818

Physical Therapy Elko Pinion Rehabilitation LLC 1775 Browning Way #203 89801 (775) 738-4494

Physical Therapy Elko Registered Physical Therapists, Inc 1501 Lamoille Way 89801 (775) 738-0818

Physical Therapy Elko Rehab Services of Nevada - Elko 2219 N. 5th St. #B 89801 (775) 738-2925

Physical Therapy Elko Ruby Mountain Physical Therapy 875 Railroad St. 89801 (775) 777-7722

Physical Therapy Fallon Fallon Physical Therapy/ Rod Stewart PT 2180 Reno Hwy. 89406 (775) 423-5233

Physical Therapy Fernley Fernley Physical Therapy aka Reno PT 20 N. West St. 89408 (775) 575-5508

Physical Therapy Fernley Physical Therapy Partners 415 Hwy 95 A South #C302 89408 (775) 575-1818

Physical Therapy Gardnerville Carson Valley Occu Health Rehab 1107 Hwy. 395 North 89410 (775) 782-1533

Physical Therapy Incline Village Incline Physical Therapy 797 Southwood Blvd. #3 89451 (775) 833-1900

Physical Therapy Minden Bodywise PT/ Monique Haviland MSPT 1667 Lucerne Dr. #B 89423 (775) 783-7606

Physical Therapy Minden High Desert Therapists 1701 County Rd. #B 89432 (775) 782-4466

Physical Therapy Reno Advanced Testing / Fischer-Cohen, Pam OTR 6490 S. McCarran Blvd. E 89509 (775) 826-3455

Physical Therapy Reno ATS Physical Therapy/ Ross Waltz 5990 Silver Lake Blvd. #D 89506 (775) 337-8776

Physical Therapy Reno ATS Physical Therapy/ Ross Waltz 850 Mill St. #300 89502 (775) 337-8776

Physical Therapy Reno Back In Motion 10789 Double 'R' Blvd. #100 89521

Physical Therapy Reno Back In Motion 10789 Double 'R' Blvd. #100 89521

Physical Therapy Reno Custom Physical Therapy 6140 Mae Anne Ave. #1B 89523 (775) 746-9224

Physical Therapy Reno High Desert Therapists 3971 S. McCarran Blvd. 89706 (775) 284-2984

Physical Therapy Reno Nevada Hand Therapy, LLC 540 W Plumb Ln. # 201 89509 (775) 853-7513

Physical Therapy Reno Nevada Physical Therapy UNR Sports Med Complex 89507 (775) 784-1999

Physical Therapy Reno Peak PT/dba Galena Physical Therapy 16560 Wedge Pkwy # 200A 89511 (775) 385-1400

Physical Therapy Reno Performance Physical Therapy, Inc. 720 Robb Dr. # 103 89523 (775) 787-3733

Physical Therapy Reno Premier Physical Therapy & Sports 615 Sierra Rose Dr. #2A 89511 (775) 828-9724

Physical Therapy Reno Reno Orthopaedic Clinic 10085 Double 'R' Blvd. #220 89521 (775) 786-3040

Physical Therapy Reno Reno Sport and Spine Institute/ dba Sidener PT 5590 Kitzke Ln. 89511 (775) 284-4774

Physical Therapy Reno Reno Sport and Spine Institute/ dba Sidener PT 970 Roberta lane # 100 89431 (775) 331-3030

Physical Therapy Reno Renown Occu Health Rehab 10101 Double 'R' Blvd. 89521 (775) 982-7000

Physical Therapy Reno Renown Occu Health Rehab 901 E. 2nd St. #101 89502 (775) 982-5001

Physical Therapy Reno Sidener PT aka Reno Sport and Spine Institute/dba Sidener PT15 McCabe Dr. #101 89511 (775) 788-5599

Physical Therapy Reno Sierra Reg Spine/ Southwest Reno Physical Therapy 6630 S. McCarran Blvd. #A6 89509 (775) 828-2866

Physical Therapy Reno Sierra Regional Spine Physical Therapy 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Physical Therapy Reno Spine Nevada 9990 Double 'R' Blvd. #200 89521 (775) 348-8800

Physical Therapy Reno The Finley Center/ Finley, Brian, PT 6490 W. McCarran Blvd. #F52 89509 (775) 337-1334

Physical Therapy S. Lake Tahoe Barton Memorial Hospital (PT) 2170 South Ave. 96150 (530) 541-3420

Physical Therapy S. Lake Tahoe Mind Body PT 2877 Lake Tahoe Blvd. #D 96150 (530) 541-7133

Physical Therapy Sparks Aquatic Physical Therapy of Nevada 1400 Baring Blvd. 89431 (775) 771-5863

Physical Therapy Sparks Back 2 Backs, Inc 975 Roberta Ln. 89431 (775) 358-5400

Physical Therapy Sparks Custom Physical Therapy 1450 E. Prater Way #103 89431 (775) 331-1199

Physical Therapy Sparks PT & Sports Rehab Center of Sparks aka Moreland 2225 N. McCarran Blvd. 89431 (775) 359-1199

Physical Therapy Sparks Renown Occu Health Rehab 910 Vista Blvd. 89434 (775) 982-5000

Physical Therapy Sparks Spine Nevada 780 Vista Blvd. #100 89434 (775) 348-8800

Physical Therapy Winnemucca Humboldt Physical Therapy 3300 Traders Way #C 89445 (775) 623-4813

Physical Therapy Winnemucca Rehab & Industrial Services aka Rehab Services of Nev 325 Hanson St. 89445 (775) 625-2222

Plastic Surgery Carson City Gabriel, Kent W., MD 704 West Nye Lane # 102 89703 (775) 885-8890

This provider list is subject to change without prior notice page 5

Page 30: Please send the Form C3 and the medical slip to

INJURY CARE OF NEVADA

Master Provider Directory-Northern Nevada

Speciality City Name Facility Address Zip Phone

Plastic Surgery Reno Dahan, Philip E., MD 10755 Double 'R' Blvd. 89521 (775) 826-4477

Plastic Surgery Reno Hall, Wesley W., MD/ Plastic & Reconst Surg 635 Sierra Rose Dr. 89511 (775) 324-1871

Plastic Surgery Reno Janiga, Timothy MD 500 Damonte Ranch Pkwy. #703 89521 (775) 398-4601

Plastic Surgery Reno Kiener, Joseph L., MD 530 Hammill Ln. 89511 (775) 825-1234

Plastic Surgery Reno McCormack, Tiffany, MD/ McCormack Plastic Surgery 10791 Double 'R' Blvd. 89511 (775) 284-2020

Plastic Surgery Reno Murphy, James E., MD/ No Nv PlastSurg 10401 Double 'R' Blvd. 89521 (775) 322-3446

Plastic Surgery Reno Wrye, Scorr W., MD/ Plastic & Reconst Surg 635 Sierra Rose Dr. 89511 (775) 324-1871

Podiatry Carson City Bean, Jeffery, MD/ Sierra Podiatry 1801 N. Carson St. 89701 (775) 882-1441

Podiatry Reno Chambers, Joseph E., DPM 75 Pringle Way #302 89502 (775) 329-8866

Podiatry Sparks Ford, L. Bruce, DPM/ Foot Surg. Assoc. 2321 Pyramid Way 89431 (775) 331-1919

Psychology Reno Lewandowski, Michael J., PhD 5421 Kietzke Ln. #101 89511 (775) 828-2955

Psychology Reno Tearnan, Blake, PhD/ Behavioral Med Assoc 5470 Kietzke Ln. #300 89511 (775) 827-8883

Radiology Carson City Great Basin Imaging 2874 N. Carson St. #300 89706 (775) 888-1180

Radiology Carson City Sierra Surgery and Imaging 1400 Medical Pkwy. 89703 (775) 883-1700

Radiology Carson City Tahoe Carson Radiology 1400 Medical Pkwy. 89703 (775) 883-1700

Radiology Carson City Tahoe Carson Radiology 1600 Medical Pkwy. 87903 (775) 445-8000

Radiology Carson City Tahoe Carson Radiology 2874 N. Carson St. 89703 (775) 888-1180

Radiology Carson City Tahoe Carson Radiology 2874 N. Carson St. #300 89706 (775) 888-1180

Radiology Elko High Desert Imaging 9706 Mountain City Highway 89801 (775) 621-5800

Radiology Ely Northstar Imaging at William Bee Ririe Hosp. 1500 Avenue 'H' 89301 (775) 289-3001

Radiology Fernley Fernley Urgent Care Rad/ Med Imag 1343 W. Newlands Dr. 89408 (775) 982-4160

Radiology Gardnerville Carson Valley Med Center Rad/ Med Imag 1107 Hwy. 395 North 89410 (775) 782-1533

Radiology Hawthorne Northstar Imaging

1st & A Streets - Mount Grant General

Hospital 89415 (775) 945-2461

Radiology Hawthorne Tahoe Carson Radiology 200 S. 'A' Street 89415 (775) 945-2461

Radiology Lovelock Northstar Imaging at Pershing Gen. Hosp 855 6th St - Pershing General Hospital 89419 (775) 273-2621

Radiology Minden Tahoe Carson Radiology 925 Ironwood Dr. 89423 (775) 445-7800

Radiology Reno Radiology Consultants LLC dba Reno Diag Ctr 590 Eureka Ave. 89512 (775) 323-5083

Radiology Reno Radiology Consultants LLC dba Reno Diag Ctr 625 SierraRose Dr. 89510 (775) 323-5083

Radiology Reno Reno Radiological Associates 50 Kirman Ave. 89502 (775) 982-4080

Radiology Reno Reno Radiological Associates 77 Pringle Way 89502 (775) 982-4160

Radiology Reno Renown Occu Health Rad/ Med Imag 6630 S. McCarran Blvd. 89509 (775) 982-8100

Radiology Reno Renown Occu Health Rad/ Med Imag 75 Kirman Ave. 89502 (775) 982-8100

Radiology Reno Renown Occu Health Rad/ Med Imag 75 Pringle Way 89502 (775) 982-8100

Radiology Reno Renown Occu Health Rad/ Med Imag 85 Kirman Ave. #2A 89502 (775) 982-5770

Radiology Reno Renown Occu Health Rad/ Med Imag 975 Ryland St. #100 89502 (775) 982-8101

Radiology Reno Renown Regional Med Ctr Rad/ Med Imag 1155 Mill St. 89502 (775) 982-8100

Radiology Reno Renown South Meadows Rad/Med Imag 10101 Double 'R' Blvd. 89520 (775) 982-8100

Radiology Sparks Renown Occu Health Rad/ Med Imag 910 Vista Blvd. 89434 (775) 982-7039

Radiology Winnemucca Northstar Imaging

11 E Haskell St - Humboldt General

Hospital 89445 (775) 623-5222

Radiology Yerington Tahoe Carson Radiology 213 S. Whitacre St. 89447 (775) 463-2301

Rehab/Occu Therapy Reno Renown Rehabilitation Hospital 1495 Mill St. 89502 (775) 982-3500

Speech Therapy Carson City Carson Tahoe Therapy 1122 So. Stewart 89701 (775) 885-6686

Spine Surgery Carson City Fry, Michael F. MD/ Tahoe Fracture 973 Mica Dr. #201 89705 (775) 392-3680

Spine Surgery Carson City Jones, David MD/ Tahoe Fracture 973 Mica Dr. #201 89705 (775) 392-3680

Spine Surgery Carson City Medoza Marco MD/ Reno Orthopaedic Clinic 973 Mica Dr. #201 89705 (775) 392-3680

Spine Surgery Reno Arraiz, Martin Jose MD/ Reno Orthopaedic Clinic 555 N. Arlington Ave. 89503 (775) 786-3040

Spine Surgery Reno Fry, Micael F. MD/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Spine Surgery Reno Jones, David MD/ Tahoe Fracture 18653 Wedge Pkwy #120 89512 (775) 392-3680

Spine Surgery Reno Kip, Phelps, MD/ Sierra Regional Spine 6630 S. McCarran Blvd. #A4 89509 (775) 392-3680

Spine Surgery Reno Medoza, Marco MD/ Tahoe Fracture 973 Mica Dr. #291 89705 (775) 392-3680

Spine Surgery Reno Rappaport, James R., MD/ Sierra Regional Spine 6630 S. McCarran Blvd. #A4 89509 (775) 828-2873

Spine Surgery Reno Sekhon, Lali H., MD PhD/ Sierra Neurosurgery 555 N. Arlington Ave. 89503 (775) 786-4030

Spine Surgery Reno Spine Nevada 9990 Double 'R' Blvd. #200 89521 (775) 348-8800

Spine Surgery Reno Witmer, Bruce MD/ Reno Orthopedic 555 N. Arlington Ave. 89503 (775) 786-3040

Surgery Center Carson City Carson Tahoe Surgery Center 973 Mica Dr. #102 89705 (775) 267-2992

Surgery Center Carson City Sierra Center for Foot Surgery 1801 N. Carson St. 89706 (775) 882-1441

Surgery Center Carson City Sierra Surgery Hospital 1400 Medical Pkwy. 89703 (775) 883-1700

Surgery Center Carson City Western Nevada Surgical Center 1299 N. Mountain St. 89703 (775) 882-4477

Surgery Center Elko Great Basin Surgical Center 2001 Errecart Blvd. 89801 (775) 753-4700

Surgery Center Reno Quail Surgical & Pain Management 6630 S. McCarran Blvd. #C25 89509 (775) 827-7555

Surgery Center Reno Reno Orthopaedic Surgery Center 350 W. 6th St. #1E 89503 (775) 786-3040

Surgery Center Reno Summit Surgery Center at St Mary's Galena 18653 Wedge Pkwy. #170 89511 (775) 674-5252

Surgery Center Reno Surgery Center of Reno 343 Elm St. #100 89503 (775) 336-6900

Surgery Center Sparks Ford Center For Foot Surgery 2321 Pyramid Way 89431 (775) 331-1919

Vascular Surgery Carson City Dipaolo, Christopher MD/ Carson Tahoe Cardio 1470 Medical Pkwy. #160 89706 (775) 445-7650

Vascular Surgery Reno General and Vascular Assoc 1500 E. 2nd St. #206 89502 (775) 789-7050

Vascular Surgery Reno Western Surgical Group 75 Pringle Way #1002 89502 (775) 323-7500

This provider list is subject to change without prior notice page 6