Charles Renick

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

3406 Glacier Hwy
Juneau, AK 99801-7251

Phone

(907) 463-3303

NPI assigned

Sep 17, 2014

Sex

Male

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 AK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jamhi Health and Wellness, IncGroup PAC ID 5799677480, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Jamhi Health & Wellness, Inc

  • Community/Behavioral Health Agency
  • Juneau, AK
  • NPI 1720126626
  Medicare reassignment Care Compare group NPD
• Jamhi Health & Wellness, Inc

  • Federally Qualified Health Center (FQHC)
  • Juneau, AK
  • NPI 1619561388
  NPD
• Wright Institute

  • Clinic/Center
  • Berkeley, CA
  • NPI 1174807507
  NPD (past)

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1629470026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 GLACIER HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017251",
            "telephone_number": "907-463-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 GLACIER HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017251",
            "telephone_number": "907-463-3303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2728 Durant Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947041725",
            "country_code": "US",
            "telephone_number": "510-841-9230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENICK",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Reid
• Meranda Reid
• Alyssa Kathleen Perry Reis, NCBTMB MT, CLT
• Jon A Reiswig, MD,
• Jacquelyn Eve Relihan
• Montanna Rae Requa
• Resiliency Counseling Services LLC
• Dany Reyes
• Jane Apple Reynolds
• Lee Reynolds

• Psychologist in Juneau, AK
• Providers in Juneau, AK by specialty
• Psychologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.