Star of Renewal LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

STAR OF RENEWAL LLC

Doing business as

Renewal Physical Therapy

Practice address

2925 SE Division St
#102
Portland, OR 97202

Phone

(503) 893-8824

NPI assigned

Feb 1, 2016

Organization subpart

No

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

Authorized official

Name

Lisa A Friedman

Title

Owner Member

Phone

(808) 346-8808

Specialties & licenses 2

Addresses

Other names 1

• Renewal Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1215395629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 HWY 101 N",
            "address_2": "STE 11-142",
            "city": "GEARHART",
            "state": "OR",
            "postal_code": "97138",
            "telephone_number": "808-346-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 SE DIVISION ST",
            "address_2": "#102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97202",
            "telephone_number": "503-893-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR OF RENEWAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "808-346-8808"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "HI",
            "license": "3604",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renewal Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriel Joseph Stapleton, MD
• Jenna Wheeler Stapleton, PHD
• Joseph Paul Stapleton, MD
• Nicole Anne Stapleton, LPN
• Christopher Stapp, RN
• Dasia Star
• Carolyn Jane Starbird, PH.D.
• Katherine Luther Starbird, L.AC.
• Zachary Nathan Starbuck
• Delta Naolin Starchild, PWS

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.