RENOVO MEDICAL LLC (NPI# 1083864219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083864219 |
| Entity Type | Organization |
| Organization Name | RENOVO MEDICAL LLC |
| Other Organization Name | UNIVERSITY MEDICAL |
| Practice Address |
816 N Campus Dr Suite 500 Garden City KS 67846-6329 |
| Practice Telephone | 6208055162 |
| Practice Fax Number | 6208055183 |
| Mailing Telephone | 6208055162 |
| Mailing Fax Number | 6208055183 |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2016-03-05 |
| Authorized Official Name | PROF. JOEL T ERSKIN (CEO/PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 6208055162 |
| Authorized Official Credential | SCD PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 202K00000X | Phlebology | 0416265 | KS | Allopathic & Osteopathic Physicians |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1500265 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
45404 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208D00000X | General Practice | KS0434389 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 055515 | 01 | |
| KS | NPI KRISTI L. SCHMITT | 1669659967 | 01 |
| KS | NPI | 1730135500 | 01 |
| KS | 200063310F | 05 | |
| KS | NPI JOEL T. ERSKIN PA-C | 1487634069 | 01 |
| FIRST GUARD | 659930 | 01 |
| Other Name | Type Code |
|---|---|
| University Medical | Doing Business As Name - Organization |
| Street Address |
816 N CAMPUS DR SUITE 500 |
| City | GARDEN CITY |
| State | KS |
| Zip Code | 67846-6329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487634069 | Joel T Erskin | Physician Assistant | 816 N Campus Dr, Suite 500, Garden City, KS 67846-6329 | 2006-01-19 |
| 1669659967 | Kristi L Schmitt | Nurse Practitioner | 816 N Campus Dr, Suite 500, Garden City, KS 67846-6329 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629619036 | Kayla Thackery | Speech-Language Pathologist | 2735 N Jennie Barker Rd, Garden City, KS 67846 | 2019-10-07 |
| 1477049732 | Sarah Lemmons | Specialist/Technologist | 801 Campus Dr, Athletic Department, Garden City, KS 67846 | 2018-07-10 |
| 1720571813 | Keith Earnest Venjohn | Pharmacist | 3101 East Kansas Ave, Garden City, KS 67846 | 2018-06-13 |
| 1457879017 | Jami Rae Weaver-warren | Nurse Practitioner | 302 N. Fleming Street Suite 2, Garden City, KS 67846 | 2017-09-05 |
| 1659812279 | Cynthia Brungardt | Pharmacist | 2424 N. Taylor Avenuee, Garden City, KS 67846 | 2017-03-15 |
| 1982145595 | Garden City Sr Operatons LLC | Custodial Care Facility | 2002 Labrador Boulevard, Garden City, KS 67846 | 2017-03-15 |
| 1255717559 | United Methodist Mexican American Ministries | Community/Behavioral Health | 122 W. Laurel Street, Garden City, KS 67846 | 2015-08-10 |
| 1447668629 | Zulema Salazar | Registered Nurse | 712 St. John St., Garden City, KS 67846 | 2014-07-31 |
| 1710210943 | Garden Valley Retirement Village, LLC | Skilled Nursing Facility | 1505 East Spruce Street, Garden City, KS 67846 | 2009-09-04 |
| 1720231848 | Vollertsen Family Dentistry | Health Maintenance Organization | 1402 1/2 Kansas Ave., Garden City, KS 67846 | 2008-11-03 |
| Find all providers in zip 67846 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114470010 | St Catherine Hospital | General Practice | 2051 E Mary St, Garden City, KS 67846-3617 | 2016-07-27 |
| 1780933564 | Ronald Allen Young | General Practice | 520 Franklin Avenue #102, Garden City, NY 11530 | 2012-09-07 |
| 1750503827 | Cesar Alfredo Vinueza | General Practice | 626a Us Highway 80 W, Garden City, GA 31408-3110 | 2007-05-02 |
| 1942360672 | James E Turek | General Practice | 2347 Hwy 17 Bus S, Garden City, SC 29576-7611 | 2006-12-11 |
| 1407939614 | Sarah S Jacob | General Practice | 2020 Middlebelt Rd, Garden City Medical Center PC, Garden City, MI 48135-2961 | 2006-10-23 |
| 1215922778 | Chuong Duc Le | General Practice | 912 N 5th St, Garden City, KS 67846-5640 | 2005-09-12 |
| 1447878558 | Aisha Kavumkal | General Practice | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2020-07-06 |
| 1437776085 | Kashif Khan | General Practice | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2020-06-30 |
| 1558986414 | Lakshminarasa Raju Suraparaju | General Practice | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2020-06-16 |
| 1871118190 | Ahmed Atef Elkomy | General Practice | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2020-06-11 |
| Find all providers in GARDEN CITY | ||||
| City | GARDEN CITY |
| Zip Code | 67846 |
Please comment or provide details below to improve the information on RENOVO MEDICAL LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.