Rena Mammoo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0030086 Issued in OH

Practice address

16801 Chillicothe Rd
Chagrin Falls, OH 44023-4618

Phone

(866) 389-2727

NPI assigned

Jul 27, 2015

Last updated

Nov 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Ohio LLCGroup PAC ID 2961425608, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26582/brand/1/csg/1/fhir/r4

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.

• Minuteclinic Diagnostic of Ohio LLC

  • Family Nurse Practitioner
  • Hilliard, OH
  • NPI 1699747303
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1619352168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16801 CHILLICOTHE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234618",
            "telephone_number": "440-543-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16801 CHILLICOTHE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234618",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMOO",
        "first_name": "RENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013051",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0030086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luna Living Brain Energy Spa, LLC
• Heidi Maclearie
• Rachel Macwhinnie
• Laurie Christine Maglietta
• James T. Maier, PT, MS
• Christopher F Manacci, DNP, ACNP-C
• Heather Marie Manchen, ACNP
• Manifest Holistic Centre, LLC
• Mark C. Brown, PHD,LLC
• Tara Odams Marnin, OTR/L

• Family Nurse Practitioner in Chagrin Falls, OH
• Providers in Chagrin Falls, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.