NPIMap

Organization Active NPI

Project Renewal Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1992247571
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7002161R Issued in NY
Legal business name
PROJECT RENEWAL INC
Practice address
8 E 3Rd St
New York, NY 10003-8908
Phone
(212) 533-8400
NPI assigned
Nov 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Mr. Mitchell Netburn
Title
Ceo
Phone
(212) 620-0340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7002161R NY Primary

Addresses

Primary practice location

8 E 3Rd St
New York, NY 10003-8908

Mailing address

200 Varick St
9TH Floor
New York, NY 10014-4810
Phone (212) 620-0340

Other identifiers 1

IdentifierTypeStateIssuer
01921402MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Project Renewal Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Varick St
Fl 9
New York, NY 10014
Phone (212) 620-0340

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1992247571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VARICK ST",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144810",
            "telephone_number": "212-620-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100038908",
            "telephone_number": "212-533-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT RENEWAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "NETBURN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "212-620-0340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7002161R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01921402",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.