NPIMap

Organization Active NPI

Community Care Services LLC

Doing business as Renown Health Medical Group - Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Reno, NV
National Provider Identifier
1699246124
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
COMMUNITY CARE SERVICES LLC
Doing business as
Renown Health Medical Group - Endocrinology
Practice address
10085 Double R Blvd Ste 310
Reno, NV 89521-4832
Phone
(775) 982-7260
Fax
(775) 982-7268
NPI assigned
Dec 10, 2018
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CARE SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Brett Moore
Title
Cfo Acute Care
Phone
(775) 982-6343

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

10085 Double R Blvd Ste 310
Reno, NV 89521-4832

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-5966

Other names 1

  • Renown Health Medical Group - Endocrinology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060111000900 NV Part B Supplier - Clinic/Group Practice 1951324318 Receives reassigned benefits from 762 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reno, NV; Carson City, NV; Sparks, NV; Winnemucca, NV; Fallon, NV; Fernley, NV

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

National Provider Directory

National Provider Directory
Tax ID family
Renown Behavioral Health20 organizations share this tax ID, including this one
Part of
Renown Behavioral Health

Other organizations with this tax ID 19

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

View all 19

Locations

560 W Williams Ave
Fallon, NV 89406

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1699246124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5966",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 DOUBLE R BLVD STE 310",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214832",
            "telephone_number": "775-982-7260",
            "fax_number": "775-982-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE SERVICES LLC",
        "enumeration_date": "2018-12-10",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CFO ACUTE CARE",
        "authorized_official_telephone_number": "775-982-6343"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renown Health Medical Group - Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renown Health Medical Group - Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.