Renaissance Healthcare, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

RENAISSANCE HEALTHCARE, LLC

Practice address

1302 Eddington Dr
Upper Marlboro, MD 20774-1942

Phone

(240) 425-7428

Fax

(866) 531-6484

NPI assigned

May 10, 2018

Last updated

May 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jane Ahworegba Samons, RN, BSN

Title

Don, Ceo

Phone

(240) 425-7428

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1811487382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 EDDINGTON DR.",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741942",
            "telephone_number": "240-425-7428",
            "fax_number": "866-531-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 EDDINGTON DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741942",
            "telephone_number": "240-425-7428",
            "fax_number": "866-531-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "SAMONS",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "AHWOREGBA",
        "authorized_official_title_or_position": "DON, CEO",
        "authorized_official_telephone_number": "240-425-7428",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.