NPIMap

Organization Active NPI

Renew Home Health Inc

  • Home Health Agency
  • Bountiful, UT
National Provider Identifier
1104135250
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
RENEW HOME HEALTH INC
Practice address
5280 S Commerce Dr
E160
Bountiful, UT 84010-5982
Phone
(801) 364-4250
Fax
(801) 994-1278
NPI assigned
Oct 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Mrs. Stephanie A Bear
Title
Office Manager
Phone
(435) 753-2438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

5280 S Commerce Dr
E160
Bountiful, UT 84010-5982

Mailing address

5280 S Commerce Dr
Renew Home Health
Murray, UT 84107-7926
Phone (801) 364-4250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110411000460 UT Part A Provider - Home Health Agency 5698959948 Practice locations: Murray, UT; St. George, UT

Home health agency certification: CCN 467322

Legal name
RENEW HOME HEALTH INC
Doing business as
RENEW HOME HEALTH & HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 9, 2011
Last certification
Oct 20, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jul 14, 2010 in UT
Enrollment address
5280 S Commerce Dr
Ste E160
Murray, UT 84107-5327

Care Compare: Home health agency

Medicare Care Compare
Listed as
Renew Home HealthCCN 467322
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Aug 9, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2024626Renew Home Health Inc5280 S Commerce Drive, Suite E-160, Murray, UT 84107Certificate of waiverMay 18, 2027

National Provider Directory

National Provider Directory

Locations

5280 S Commerce Dr
Murray, UT 84107

1487 S Silicon Way
Ste 1
St George, UT 84770
Phone (801) 364-4250

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jarvis S Maughan Individual 5% Or Greater Direct Ownership Interest Oct 7, 2021 7%
Aaron Scott Lewis Individual 5% Or Greater Direct Ownership InterestAdministrator/Owner Oct 7, 2021 7%
W-2 Managing EmployeeAdministrator Oct 15, 2014
Brian Zullo Individual 5% Or Greater Direct Ownership InterestOwner Oct 7, 2021 17.25%
Joshua Barlow Individual 5% Or Greater Direct Ownership InterestOwner Oct 7, 2021 17.25%
Corporate OfficerCfo, Director Oct 7, 2021
Corporate DirectorCfo, Director Oct 7, 2021
Kimball Probst Individual 5% Or Greater Direct Ownership Interest Oct 7, 2021 7%
Holly Lee Carter Individual 5% Or Greater Direct Ownership Interest Oct 7, 2021 6%
Tyler Glenn Individual 5% Or Greater Direct Ownership Interest Oct 7, 2021 17.25%
Corporate OfficerSecretary, Director Oct 7, 2021
Corporate DirectorSecretary, Director Oct 7, 2021
Jeffrey Stacy Individual 5% Or Greater Direct Ownership Interest Oct 7, 2021 17.25%
Corporate OfficerCeo, Director Oct 7, 2021
Corporate DirectorCeo, Director Oct 7, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1104135250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5280 S COMMERCE DR",
            "address_2": "RENEW HOME HEALTH",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077926",
            "telephone_number": "801-364-4250",
            "fax_number": "801-994-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5280 S COMMERCE DR",
            "address_2": "E160",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840105982",
            "telephone_number": "801-364-4250",
            "fax_number": "801-994-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "BEAR",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-753-2438",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.