NPIMap

Organization Active NPI

Community Care Services LLC

Doing business as Renown Medical Group Women's Health

  • Obstetrics & Gynecology Physician
  • Reno, NV
National Provider Identifier
1053882589
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
COMMUNITY CARE SERVICES LLC
Doing business as
Renown Medical Group Women's Health
Practice address
901 E 2ND St Ste 307
Reno, NV 89502-1178
Phone
(775) 982-5000
Fax
(775) 982-3901
NPI assigned
Dec 10, 2018
Last updated
Jun 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CARE SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Authorized official

Name
Mr. Brett Moore
Title
Cfo Acute Care
Phone
(775) 982-6343

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NU
Advanced Practice Midwife 367A00000X NU
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

901 E 2ND St Ste 307
Reno, NV 89502-1178

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-5262

Other names 1

  • Renown Medical Group Women's Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060111000900 NV Part B Supplier - Clinic/Group Practice 1951324318 Receives reassigned benefits from 762 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reno, NV; Carson City, NV; Sparks, NV; Winnemucca, NV; Fallon, NV; Fernley, NV

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D1101098Renown Medical Group Women's Health901 E Second St Ste 307, Reno, NV 89502Provider-performed microscopyJun 23, 2027

National Provider Directory

National Provider Directory
Part of
Renown Behavioral Health

Locations

901 E 2nd St
Ste 307
Reno, NV 89502
Phone (775) 982-3900

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717200000000",
    "number": "1053882589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 2ND ST STE 307",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021178",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE SERVICES LLC",
        "enumeration_date": "2018-12-10",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CFO ACUTE CARE",
        "authorized_official_telephone_number": "775-982-6343",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renown Medical Group Women's Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renown Medical Group Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.