Organization Active NPI

Renaissance Health LLC

  • Adult Health Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1104772482
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
RENAISSANCE HEALTH LLC
Practice address
3621 NW 63Rd St Ste E
Oklahoma City, OK 73116-2041
Phone
(405) 345-2982
NPI assigned
Mar 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Dr. Bhavi Shah, DNP, ANP-CNPI 1437596442
Title
Owner
Phone
(405) 410-2720

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

3621 NW 63Rd St Ste E
Oklahoma City, OK 73116-2041

Mailing address

3621 NW 63Rd St Ste E
Oklahoma City, OK 73116-2041
Phone (405) 345-2982

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260521002694 OK Part B Supplier - Clinic/Group Practice 8820568637 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

3621 NW 63rd St
Ste E
Oklahoma City, OK 73116
Phone (405) 345-2982

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1104772482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 NW 63RD ST STE E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162041",
            "telephone_number": "405-345-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 NW 63RD ST STE E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162041",
            "telephone_number": "405-345-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BHAVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-410-2720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, ANP-C"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.