NPIMap

Organization Active NPI

Renaissance Medical Group,Inc

  • Addiction (Substance Use Disorder) Counselor
  • Fairmount Heights, MD
National Provider Identifier
1689713638
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
RENAISSANCE MEDICAL GROUP,INC
Practice address
525 Eastern Ave Ste B3
Fairmount Heights, MD 20743-1677
Phone
(301) 925-2255
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Andrea L Syphax
Title
Administrator
Phone
(301) 925-2255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X MD Primary

Addresses

Primary practice location

525 Eastern Ave Ste B3
Fairmount Heights, MD 20743-1677

Mailing address

PO Box 2966
Hyattsville, MD 20784-0966

Other names 1

  • RenaissanceTreatment Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Medical Group Inc2 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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689713638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2966",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207840966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 EASTERN AVE STE B3",
            "city": "FAIRMOUNT HEIGHTS",
            "state": "MD",
            "postal_code": "207431677",
            "telephone_number": "301-925-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL GROUP,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SYPHAX",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-925-2255"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RenaissanceTreatment Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairmount Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.