Renew Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RENEW PHYSICAL THERAPY, LLC

Practice address

1415 Casady LN
The Village, OK 73120-1609

Phone

(405) 318-7390

NPI assigned

Aug 14, 2023

Organization subpart

No

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

Authorized official

Name

Benjamin Burke, DPTNPI 1588390330

Title

Owner

Phone

(405) 318-7390

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Robert Burke, DPT

  • Physical Therapist
  • The Village, OK
  • NPI 1588390330
  NPD Authorized official

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1063295202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 CASADY LN",
            "city": "THE VILLAGE",
            "state": "OK",
            "postal_code": "731201609",
            "telephone_number": "405-318-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 CASADY LN",
            "city": "THE VILLAGE",
            "state": "OK",
            "postal_code": "731201609",
            "telephone_number": "405-318-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-318-7390",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tango L. McCauley Sr.
• Carter Mark Methvin
• Leroy Ngo
• Pruett'S Food, Inc.
• Nicole Ray
• Bradley Allen Sablatura, PHARMD
• Kerry Leon Seay
• Allison Stephens, PHARM D
• Vonya Nicole Streetz, PHARMD
• Chris D Taylor Sr.

• Physical Therapy Clinic/Center in The Village, OK
• Providers in The Village, OK by specialty
• Physical Therapy Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.