NPIMap

Individual provider Active NPI

Charlotte Anne Kermode, APN, FNP-BC

  • Family Nurse Practitioner
  • Reno, NV
National Provider Identifier
1396992780
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN001071 Issued in NV
Practice address
13945 S Virginia St
#632
Reno, NV 89511
Phone
(775) 982-5000
Fax
(775) 982-3900
NPI assigned
Aug 27, 2008
Last updated
Oct 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN001071 NV Primary

Addresses

Primary practice location

13945 S Virginia St
#632
Reno, NV 89511

Mailing address

850 Harvard Way # T5
Reno, NV 89502-2055
Phone (775) 982-5262

Other identifiers 1

IdentifierTypeStateIssuer
11934135OtherCAQH

Other names 1

  • Charlotte Anne Hartzog Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000528 NV Practitioner - Nurse Practitioner 6709929631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13945 S Virginia St
Suite 632
Reno, NV 89511-8930
Phone (775) 982-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.15 of 100Reported as group
Quality
78.17
Promoting interoperability
100
Improvement activities
40
Cost
75.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN001071NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Health Management Company CurrentSince Nov 23, 2009 Accepting new patients
Hometown Health Management Company CurrentSince Nov 23, 2009 Accepting new patients
Hometown Health Management Company Past Accepting new patients

Locations

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

13945 S Virginia St
Ste 632
Reno, NV 89511
Phone (755) 982-5000

850 Harvard Way
#T5
Reno, NV 89502

975 Ryland St
Ste 100
Reno, NV 89502
Phone (775) 982-5210

Interoperability endpoints

  • Direct secure messaging: ckermode10991@direct.renown.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1396992780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY # T5",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13945 S VIRGINIA ST",
            "address_2": "#632",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERMODE",
        "first_name": "CHARLOTTE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN001071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11934135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOTTE",
            "last_name": "HARTZOG",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.