NPIMap

Organization Active NPI

Renew Health & Physical Therapy , LLC

  • Physical Therapy Clinic/Center
  • Whiteville, NC
National Provider Identifier
1073025631
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RENEW HEALTH & PHYSICAL THERAPY , LLC
Practice address
812 Pinckney St
Whiteville, NC 28472-3308
Phone
(910) 207-6696
NPI assigned
Nov 3, 2017
Last updated
Nov 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Authorized official

Name
Micah Merritt, DPTNPI 1740440569
Title
Owner/Physical Therapist
Phone
(910) 207-6696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

812 Pinckney St
Whiteville, NC 28472-3308

Mailing address

812 Pinckney St
Whiteville, NC 28472-3308
Phone (910) 207-6696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180205000946 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4486914827 Receives reassigned benefits from 5 practitioners
Practice locations: Elizabethtown, NC; Tabor City, NC; Whiteville, NC

National Provider Directory

National Provider Directory

Locations

104 E 5th St
Tabor City, NC 28463
Phone (910) 207-6696

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1073025631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 PINCKNEY ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723308",
            "telephone_number": "910-207-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 PINCKNEY ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723308",
            "telephone_number": "910-207-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW HEALTH & PHYSICAL THERAPY , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "MICAH",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "910-207-6696",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.