Renaissance Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

RENAISSANCE HEALTHCARE LLC

Practice address

6422 E Main St Ste 205
Reynoldsburg, OH 43068-2302

Phone

(614) 626-2101

Fax

(614) 626-2501

NPI assigned

Mar 15, 2013

Last updated

Apr 30, 2015By 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

Nicole N Olama

Title

Chief Operating Officer

Phone

(614) 626-2101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548501539. Details of each certification follow.

• CCN 369273 Home health agency · Active · Details

Home health agency certification: CCN 369273

Legal name

RENAISSANCE HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 21, 2021

Last certification

Jan 21, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

6422 E Main St
Ste 205
Reynoldsburg, OH 43068-2302

Listed as

Renaissance Healthcare LLCCCN 369273 · All quality measures

Ownership

Proprietary

Certified

Jan 21, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1548501539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6422 E MAIN ST STE 205",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682302",
            "telephone_number": "614-626-2101",
            "fax_number": "614-626-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6422 E MAIN ST STE 205",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682302",
            "telephone_number": "614-626-2101",
            "fax_number": "614-626-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "OLAMA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "614-626-2101"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.