Renewed1 LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

RENEWED1 LLC

Practice address

401 Ryland St Ste 200a
Reno, NV 89502-1643

Phone

(702) 350-1387

NPI assigned

Sep 7, 2024

Last updated

Sep 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amon Denzel Lester, FNP-CNPI 1194389569

Title

Owner

Phone

(702) 350-1387

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Amon Denzel Lester, FNP-C

  • Family Nurse Practitioner
  • Henderson, NV
  • NPI 1194389569
  NPD Authorized official

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

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725667200000",
    "number": "1316772387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RYLAND ST STE 200A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021643",
            "telephone_number": "702-350-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RYLAND ST STE 200A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021643",
            "telephone_number": "702-350-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "AMON",
        "authorized_official_middle_name": "DENZEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-350-1387",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194389569",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Reno, NV
• Providers in Reno, NV by specialty
• Multi-Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.