NPIMap

Organization Active NPI

Renown South Meadows Medical Center

  • General Acute Care Hospital
  • Reno, NV
National Provider Identifier
1720058027
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2373HOS-17 Issued in NV
Legal business name
RENOWN SOUTH MEADOWS MEDICAL CENTER
Practice address
10101 Double R Blvd
Reno, NV 89521-5931
Phone
(775) 982-7000
Fax
(775) 982-7089
NPI assigned
Jan 26, 2006
Last updated
Apr 9, 2025By the provider in NPPES
Organization subpart
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2373HOS-17 NV Primary

Addresses

Primary practice location

10101 Double R Blvd
Reno, NV 89521-5931

Mailing address

1155 Mill St
Central Business Office N-12
Reno, NV 89502-1576
Phone (775) 982-7000

Other identifiers 7

IdentifierTypeStateIssuer
CC7515OtherNVBCBS
XHSP43672MedicaidCA
V100380OtherMEDICARE PART B
100502742MedicaidNV
100502741MedicaidNV
290049OtherCABLUE CROSS OF CA
XHSP33672MedicaidCA

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000152 NV Part A Provider - Hospital 1355236449 Practice locations: Sparks, NV; Reno, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720058027. Details of each certification follow.

Hospital certification: CCN 290049

Legal name
RENOWN SOUTH MEADOWS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 1, 2004
Last certification
May 3, 2022
Beds
118 (98 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 3, 2002 in NV
Enrollment address
10101 Double R Blvd
Reno, NV 89521-5931
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Renown South Meadows Medical CenterCCN 290049 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christopher J Ott Individual Corporate DirectorBoard Member Jan 1, 2026
Brian E Sandoval Individual Corporate DirectorBoard Member Jan 1, 2022
Rebecca Cross Individual W-2 Managing Employee Feb 2, 2026
Jeff D Eller Individual Corporate DirectorBoard Member Jan 1, 2005
Adam O Kramer Individual Corporate DirectorMember Jul 1, 2017
Bijel K Doshi Individual Corporate DirectorBoard Member Jan 1, 2022
Brian F Erling Individual Corporate OfficerCeo Nov 14, 2022
Corporate DirectorCeo Nov 14, 2022
Stephanie D Lepori Individual Corporate DirectorBoard Member Apr 1, 2023
Brett Moore Individual Corporate OfficerCfo Acute Care Jul 12, 2021
W-2 Managing EmployeeCfo Acute Care Jul 12, 2021
Renown Health Organization, Reno, NV Non-profit 5% Or Greater Direct Ownership Interest Sep 3, 2002 100%
Anna Loomis Individual Corporate OfficerCfo Renown Health Jul 8, 2024
W-2 Managing EmployeeAd; Jul 8, 2024
Thomas Deveny Individual Corporate Director Jan 1, 2017
Samuel Weller Individual W-2 Managing EmployeeCeo Renown South Meadows Jun 26, 2023
Tamara Dermody Individual Corporate DirectorDirector Jan 1, 2019
Marc W Mora Individual Corporate DirectorBoard Member Jan 1, 2022

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

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 17

Affiliated clinicians 900

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 900

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1720058027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "address_2": "CENTRAL BUSINESS OFFICE N-12",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-7000",
            "fax_number": "775-982-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 DOUBLE R BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215931",
            "telephone_number": "775-982-7000",
            "fax_number": "775-982-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOWN SOUTH MEADOWS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NV",
            "license": "2373HOS-17",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CC7515",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP43672",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "V100380",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502742",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502741",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CA",
            "identifier": "290049",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP33672",
            "state": "CA"
        }
    ],
    "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": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.