Renaissance Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RENAISSANCE MEDICAL LLC

Practice address

1380 W 5TH St
London, KY 40741-1615

Phone

(606) 878-0453

Fax

(606) 878-1862

NPI assigned

Apr 25, 2007

Last updated

Jun 2, 2020By 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

Mr. James C Graham

Title

President

Phone

(606) 878-7522

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Renaissance Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Frankfort, KY
  • NPI 1841419926

  3971624560

  Same PAC ID
• Renaissance Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
  • NPI 1982606851

  3971624560

  Same PAC ID

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

Medicare medical equipment & supply locations

Tax ID family

Renaissance Medical LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Renaissance Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Frankfort, KY
  • NPI 1841419926
  NPD tax ID
• Renaissance Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
  • NPI 1982606851
  NPD tax ID

Locations

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1194944363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 W 5TH ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411615",
            "telephone_number": "606-878-0453",
            "fax_number": "606-878-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 W 5TH ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411615",
            "telephone_number": "606-878-0453",
            "fax_number": "606-878-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-878-7522",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100205920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Reed, LCSW
• Leasha Dawn Reed, BA, LPCC
• Madisyn Breann Reed, OTR/L
• Robert Sidney Reffner, D.O.
• Samantha Nicole Reid, BS, LPCC
• Lynnett L Renner, RD, LDE
• Revolution Physical Therapy
• Megan R Reynolds, APRN
• Hannah E Rice, MSN, APRN, PMHNP-BC
• Ladonya Brittany Rice, HIS

• Durable Medical Equipment & Medical Supplies in London, KY
• Providers in London, KY by specialty
• Durable Medical Equipment & Medical Supplies in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.