NPIMap

Organization Active NPI

Renew Wound Care Specialists

  • Nurse Practitioner
  • Cornelius, NC
National Provider Identifier
1154087864
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RENEW WOUND CARE SPECIALISTS
Practice address
18805 W Catawba Ave Ste 205a
Cornelius, NC 28031-4609
Phone
(704) 612-0011
NPI assigned
Nov 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Coral KirscherNPI 1659819001
Title
Owner
Phone
(704) 310-1043

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

18805 W Catawba Ave Ste 205a
Cornelius, NC 28031-4609

Mailing address

18805 W Catawba Ave Ste 205a
Cornelius, NC 28031-4609
Phone (704) 612-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211210000246 NC Part B Supplier - Clinic/Group Practice 1153711940 Receives reassigned benefits from 7 practitioners
Practice locations: Cornelius, NC
O20250915000133 SC Part B Supplier - Clinic/Group Practice 1153711940 Receives reassigned benefits from 4 practitioners
Practice locations: North Charleston, SC

National Provider Directory

National Provider Directory

Locations

18805 W Catawba Ave
Ste 205A
Cornelius, NC 28031
Phone (704) 310-1043

18805 W Catawba Ave
Ste 100
Cornelius, NC 28031
Phone (704) 612-0011

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1154087864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 205A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314609",
            "telephone_number": "704-612-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 205A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314609",
            "telephone_number": "704-612-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW WOUND CARE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "KIRSCHER",
        "authorized_official_first_name": "CORAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-310-1043"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.