Renew Healthcare LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

MD18043 Issued in OR

Legal business name

RENEW HEALTHCARE LLC

Practice address

2937 NW Highway 101
Suite 110
Lincoln City, OR 97367-4442

Phone

(541) 614-0314

NPI assigned

Jul 11, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Joanne Engel Kort, CNP, CNM, MPH

Title

Certified Nurse Practitioner

Phone

(503) 269-3495

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Renew Clinic & Spa Other name

Locations

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1063777415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827",
            "city": "NEOTSU",
            "state": "OR",
            "postal_code": "973640827",
            "telephone_number": "503-269-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 NW HIGHWAY 101",
            "address_2": "SUITE 110",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674442",
            "telephone_number": "541-614-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KORT",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "ENGEL",
        "authorized_official_title_or_position": "CERTIFIED NURSE PRACTITIONER",
        "authorized_official_telephone_number": "503-269-3495",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNP, CNM, MPH"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "MD18043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "049796",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049796",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Clinic & Spa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Parker Preston, LPC, QMHP, CADCIII
• Darrell Duane Prins, D.P.M.
• Arnulfo Jr Puentes
• Arun Raman, M.B.,B.S.
• Timothy Rash
• Renew Womancare LLC
• Renovo Chiropractic LLC
• Amber Reyes
• Rory Fleming Richardson, PH.D., FICPPM
• Kay Riedl

• Health Maintenance Organization in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Health Maintenance Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.