Organization Active NPI

Renown Businesses

Doing business as Boutique at Renown

  • Durable Medical Equipment & Medical Supplies
  • Reno, NV
National Provider Identifier
1467558668
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
MP00115 Issued in NV
Legal business name
RENOWN BUSINESSES
Doing business as
Boutique at Renown
Practice address
75 Pringle Way Ste 107
Reno, NV 89502-8424
Phone
(775) 982-5075
Fax
(775) 982-5005
NPI assigned
Sep 15, 2006
Last updated
Jan 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
RENOWN BUSINESSESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MP00115 NV Primary
Durable Medical Equipment & Medical Supplies 332B00000X 68527 NV

Addresses

Primary practice location

75 Pringle Way Ste 107
Reno, NV 89502-8424

Mailing address

75 Pringle Way Ste 107
Reno, NV 89502-8424
Phone (775) 982-5075

Other names 1

  • Boutique at Renown Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930019199 NV DME Supplier - Medical Supply Company With Prosthetic Personnel 4981500485 Practice locations: Reno, NV

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Lactation Connection75 Pringle Way, Reno, NV 89502-8424(775) 982-5075 Breast Prostheses and/or Accessories Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Washoe Professional Cen2 organizations share this tax ID, including this one
Part of
Washoe Professional Cen

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

Locations

75 Pringle Way
Ste 107
Reno, NV 89502
Phone (775) 982-5075

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1467558668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 107",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895028424",
            "telephone_number": "775-982-5075",
            "fax_number": "775-982-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 107",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895028424",
            "telephone_number": "775-982-5075",
            "fax_number": "775-982-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOWN BUSINESSES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RENOWN BUSINESSES",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NV",
            "license": "MP00115",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NV",
            "license": "68527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boutique at Renown",
            "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 Jan 3, 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.