Renaissance Medical Spa, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

01047137 Issued in IN

Legal business name

RENAISSANCE MEDICAL SPA, LLC

Practice address

1414 E Tipton St
Seymour, IN 47274-3533

Phone

(812) 524-9222

Fax

(812) 524-9777

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Palmer Snook, M.D.

Title

Owner

Phone

(812) 524-9222

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Renaissance Medical Spa LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Renaissance Medical Spa, L.L.C.

  • Family Medicine Physician
  • Seymour, IN
  • NPI 1275865446
  NPD tax ID

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043357726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472743533",
            "telephone_number": "812-524-9222",
            "fax_number": "812-524-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472743533",
            "telephone_number": "812-524-9222",
            "fax_number": "812-524-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNOOK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PALMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-524-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "01047137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "067386",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000352813",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Reichenbacker
• Stacey Reichenbacker, MS, NBC-HWC, CHWC
• Reins to Recovery, Inc.
• Remedy Acupuncture LLC
• Renaissance Medical Spa, L.L.C.
• Renew Behavior Services LLC
• Lisa Dawn Reynolds
• Cynthia Louise Rice
• Aeriel Rose Richardson, RN
• Lyda E. Ritz

• Primary Care Clinic/Center in Seymour, IN
• Providers in Seymour, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.