NPIMap

Individual provider Active NPI

Renetta Elaine Brewer, NP-C

  • Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1750733408
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN80717-NP-C Issued in WV
Practice address
4610 Kanawha Ave SW
Suite 402
South Charleston, WV 25309-1367
Phone
(304) 400-4700
NPI assigned
Jul 6, 2016
Last updated
Jul 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN80717-NP-C WV Primary

Addresses

Primary practice location

4610 Kanawha Ave SW
Suite 402
South Charleston, WV 25309-1367

Mailing address

4610 Kanawha Ave SW
Suite 402
South Charleston, WV 25309-1367
Phone (304) 400-4700

Other names 1

  • Renetta Elaine Deskins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161108001795 WV Practitioner - Nurse Practitioner 7113206582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Nephrology Hypertension and Transplant PLLCGroup PAC ID 0042301814, 6 clinicians

Practice addresses (Care Compare)

122 Pinnell St
BLDG 6
Ripley, WV 25271-9101
Phone (304) 400-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN80717-NP-CWVMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: rbrewer24333@direct.acumenmd.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1750733408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW",
            "address_2": "SUITE 402",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-400-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW",
            "address_2": "SUITE 402",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-400-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "RENETTA",
        "middle_name": "ELAINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "APRN80717-NP-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENETTA",
            "last_name": "DESKINS",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.