Renaissance Womens Center, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01026315A Issued in IN

Legal business name

RENAISSANCE WOMENS CENTER, LLC

Practice address

6111 Harrison St
Suite 255
Merrillville, IN 46410-2969

Phone

(773) 887-7313

NPI assigned

Dec 26, 2007

Last updated

Jun 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deborah Lynne McCullough, MD

Title

Ceo/Owner

Phone

(219) 887-7313

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1124202262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 HARRISON ST",
            "address_2": "SUITE 255",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102969",
            "telephone_number": "773-887-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 HARRISON ST",
            "address_2": "SUITE 255",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102969",
            "telephone_number": "773-887-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE WOMENS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "219-887-7313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01026315A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000084532",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100147650A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Relational Wellness Therapy and Consulting
• Shakira Releford
• Reliable Potential Physical Therapy PC
• Reliance Physical Therapy and Wellness Center Inc
• Rem Indiana (Indiana Mentor)
• Shyanne Render, LSW
• Residential Clinical Services, Inc.
• Responsive Home Health Care Inc (Hook's Oxygen & Medical Equipment)
• Angelique Retic
• Retina Associates, PC

• Obstetrics & Gynecology Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.