Renviva LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

RENVIVA LLC

Practice address

1235 N Mulford Rd
Rockford, IL 61107-3879

Phone

(513) 673-5245

Fax

(866) 352-4339

NPI assigned

Oct 16, 2015

Last updated

Sep 26, 2016By 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

Ms. Sandra Diane Fritzsch

Title

Member Manager

Phone

(513) 673-5245

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Renviva, LLCCCN 142803

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Aug 8, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

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

• Renviva Nursing Home Services LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Harwood Heights, IL
  • NPI 1588167977

  Member Of

  NPD member

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

• Renviva Nursing Home Services LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Harwood Heights, IL
  • NPI 1588167977

  Member Of

  NPD member
• Renpro Indiana LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lebanon, IN
  • NPI 1255971362

  Member Of

  NPD member
• Renviva Dialysis Center of Clearwater

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Belleair, FL
  • NPI 1194178889

  Member Of

  NPD member

Locations

Affiliated clinicians 3

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

• Farhan A Khan, MD

  • Nephrology Physician
  • Freeport, IL
  • NPI 1760593693

  Dialysis facility

  Care Compare affiliation Name & address match
• Joanna M Niemiec, MD

  • Nephrology Physician
  • Rockford, IL
  • NPI 1821016791

  Dialysis facility

  Care Compare affiliation Name & address match
• Michael Robertson, MD

  • Nephrology Physician
  • Rockford, IL
  • NPI 1093717027

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1962873919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "513-673-5245",
            "fax_number": "866-352-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "513-673-5245",
            "fax_number": "866-352-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENVIVA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "FRITZSCH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "513-673-5245",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Renfro, APRN, WHNP
• Renita Shores-Gaston (Resilience Counseling)
• William S Renk, MD
• Catherine Lucas Rennert, LCPC
• Edward Paul Rentschler, DDS
• Robyn Renwick
• Reproductive Solutions LLC (Advanced Reproductive Center)
• Monica Reu
• Lindsay C Reuter, PTA
• Paul Revis, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Rockford, IL
• Providers in Rockford, IL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.