NPIMap

Organization Active NPI

Community Care Services LLC

Doing business as Community Care Services

  • Internal Medicine Physician
  • Reno, NV
National Provider Identifier
1720031768
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMMUNITY CARE SERVICES LLC
Doing business as
Community Care Services
Renown Health Hospitalist Services
Practice address
1155 Mill St
Reno, NV 89502-1576
Phone
(775) 982-5000
Fax
(775) 982-4196
NPI assigned
May 19, 2006
Last updated
Apr 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HOMETOWN HEALTH MANAGEMENT COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Clinical Cardiac Electrophysiology Physician 207RC0001X
Interventional Cardiology Physician 207RI0011X
Infectious Disease Physician 207RI0200X
Nephrology Physician 207RN0300X
Physical Medicine & Rehabilitation Physician 208100000X
Neurology Physician 2084N0400X
Radiation Oncology Physician 2085R0001X
Trauma Surgery Physician 2086S0127X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502-1576

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-5262

Other practice location 1

10101 Double R Blvd
Reno, NV 89521-3149
Phone (775) 982-7878

Other identifiers 1

IdentifierTypeStateIssuer
1720031768MedicaidNV

Other names 2

  • Community Care Services Doing business as
  • Renown Health Hospitalist Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments

Enrollment records 2

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
Practice locations: Reno, NV; Carson City, NV; Sparks, NV; Winnemucca, NV; Fallon, NV; Fernley, NV
O20150506002515 CA Part B Supplier - Clinic/Group Practice 1951324318 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Bishop, CA; Mammoth Lakes, CA; Susanville, CA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Part of
Mark J Gaetke MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10085 Double R Blvd
Ste 205
Reno, NV 89521
Phone (775) 852-0505

1145 ML St
Reno, NV 89502

1155 Mill St
#5
Reno, NV 89502

236 W 6th St
Ste 200
Reno, NV 89503
Phone (775) 329-9010

780 Kuenzli St
Ste 202
Reno, NV 89502
Phone (775) 982-4590

130 E Haskell St C
Winnemucca, NV 89445
Phone (775) 623-5074

Practitioners & affiliated clinicians

Practitioners 799

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 799

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1720031768",
    "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": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-4196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10101 Double R Blvd",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895213149",
            "country_code": "US",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CARE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOMETOWN HEALTH MANAGEMENT COMPANY",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720031768",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Community Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renown Health Hospitalist Services",
            "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 Apr 9, 2025; 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.