NPIMap

Organization Active NPI

Renaissance Medical Spa, L.L.C.

  • Family Medicine Physician
  • Seymour, IN
National Provider Identifier
1275865446
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01047137 Issued in IN
Legal business name
RENAISSANCE MEDICAL SPA, L.L.C.
Practice address
1414 E Tipton St
Seymour, IN 47274-3533
Phone
(812) 524-9222
Fax
(812) 524-9777
NPI assigned
Feb 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Authorized official

Name
Dr. John Palmer Snook, M.D.
Title
Owner
Phone
(812) 524-9222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01047137 IN Primary

Addresses

Primary practice location

1414 E Tipton St
Seymour, IN 47274-3533

Mailing address

1414 E Tipton St
Seymour, IN 47274-3533
Phone (812) 524-9222

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Medical Spa LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1414 E Tipton St
Seymour, IN 47274
Phone (812) 405-2039

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1275865446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472743533",
            "telephone_number": "812-524-9222",
            "fax_number": "812-524-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472743533",
            "telephone_number": "812-524-9222",
            "fax_number": "812-524-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL SPA, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "SNOOK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PALMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-524-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.