NPIMap

Organization Active NPI

Renovo Medical Group

  • Pulmonary Disease Physician
  • Shoreline, WA
National Provider Identifier
1649680547
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
29486 Issued in WA
Legal business name
RENOVO MEDICAL GROUP
Practice address
19930 Ballinger Way NE
Shoreline, WA 98155-1223
Phone
(425) 778-2220
NPI assigned
Apr 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Authorized official

Name
Cheryl Hamill
Title
Operations Manager
Phone
(425) 778-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 29486 WA Primary

Addresses

Primary practice location

19930 Ballinger Way NE
Shoreline, WA 98155-1223

Mailing address

19930 Ballinger Way NE
Shoreline, WA 98155-1223
Phone (425) 778-2220

National Provider Directory

National Provider Directory
Tax ID family
Renovo Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1649680547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "425-778-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "425-778-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "HAMILL",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "425-778-2220"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "29486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.