Renew Consulting Services,LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RENEW CONSULTING SERVICES,LLC

Practice address

5717 Bradford LN
Tuscaloosa, AL 35405-5680

Phone

(205) 535-0325

Fax

(205) 575-0683

NPI assigned

Apr 27, 2021

Organization subpart

No

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

Authorized official

Name

Karen Stacy Moore, MD

Title

Owner

Phone

(205) 535-0325

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1265014344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 BRADFORD LN",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354055680",
            "telephone_number": "205-535-0325",
            "fax_number": "205-575-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 BRADFORD LN",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354055680",
            "telephone_number": "205-535-0325",
            "fax_number": "205-575-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW CONSULTING SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-535-0325",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156901",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.