NPIMap

Organization Active NPI

The Renaissance Centre, Inc.

  • Psychologist
  • Albany, GA
National Provider Identifier
1104970193
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
THE RENAISSANCE CENTRE, INC.
Practice address
506 N Jackson St
Albany, GA 31701
Phone
(229) 889-7200
Fax
(229) 889-7393
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Authorized official

Name
Ms. Margaret Beck
Title
Office Manager
Phone
(229) 889-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

506 N Jackson St
Albany, GA 31701

Mailing address

506 N Jackson St.
Albany, GA 31701
Phone (229) 889-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040402001248 GA Part B Supplier - Clinic/Group Practice 4587656962 Receives reassigned benefits from 3 practitioners
Practice locations: Albany, GA

National Provider Directory

National Provider Directory

Locations

506 N Jackson St
Albany, GA 31701
Phone (229) 889-7200

533 W 3rd Ave
Albany, GA 31701
Phone (229) 889-7200

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1104970193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 N JACKSON ST.",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "229-889-7200",
            "fax_number": "229-889-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 N JACKSON ST",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "229-889-7200",
            "fax_number": "229-889-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RENAISSANCE CENTRE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-889-7200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.