Renaissance Port Inc.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

RENAISSANCE PORT INC.

Practice address

18600 Florence St
Roseville, MI 48066-6600

Phone

(877) 775-8764

NPI assigned

Mar 16, 2026

Organization subpart

No

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

Authorized official

Name

Nicole L Comer, ADMINISTRATORNPI 1922555002

Title

Manager

Phone

(877) 775-8764

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Comer

  • Community Health Worker
  • Detroit, MI
  • NPI 1922555002
  NPD Authorized official

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1770430969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28401 MOUND RD UNIT 1810",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480907264",
            "telephone_number": "877-775-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18600 FLORENCE ST",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480666600",
            "telephone_number": "877-775-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE PORT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "COMER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "877-775-8764",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Roseville, MI
• Providers in Roseville, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.