Mary-Jo Renz, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP30002251 Issued in WA

Practice address

1560 N 115TH St Ste 201
Seattle, WA 98133-8414

Phone

(206) 368-1244

Fax

(206) 368-1270

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Northwest Hospital Provider Trust

  dba Kent Sullivan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Seattle, WA
  • NPI 1770545352
  NPD (past)
• Northwest Hospital Providers Trust

  dba Northwest Hospital Provider Trust

  • Primary Care Nurse Practitioner
  • Seattle, WA
  • NPI 1073579850
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1457356222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33450",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981330450",
            "telephone_number": "206-368-1244",
            "fax_number": "206-368-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 N 115TH ST STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338414",
            "telephone_number": "206-368-1244",
            "fax_number": "206-368-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZ",
        "first_name": "MARY-JO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP30002251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00135135",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9629858",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Loren Reno, M.D.
• Scott Arnold Renschler, PSY.D.
• Jonathan Lee Renslo, MD
• Yazmin Renteria, OTR/L
• Nicola Jean Rentschler, MD
• Angela Maria Renzetti
• Cecilia Marie Reoux, CNM
• Joseph Paul Reoux, MD
• Marie C. Repanich, MS, CCC-SLP
• Daniel P Replogle, LICSW

• Gerontology Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.