Renew Weight Loss Marketing LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

RENEW WEIGHT LOSS MARKETING LLC

Practice address

6344 Camp Bowie Blvd
Fort Worth, TX 76116-5408

Phone

(817) 409-6265

NPI assigned

Jan 30, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Andrew Thomas Little

Title

Manager

Phone

(936) 577-4606

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Renew DFW Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643500800000",
    "number": "1316690472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6344 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165408",
            "telephone_number": "817-409-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6344 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165408",
            "telephone_number": "817-409-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW WEIGHT LOSS MARKETING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "936-577-4606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PRACTICE",
            "identifier": "1174117683",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://fastweightlossdallas.com/",
            "affiliation": "N",
            "endpointDescription": "Secure website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6344 Camp Bowie Blvd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761165408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Renew DFW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Logan Ray Rencher, DO
• Gabrielle Rendon, LPC
• Ashley Nicole Reneau, PT, DPT
• Renew Physical Therapy Fort Worth PLLC
• Renew Toxicology
• Renewed Life Residence LLC
• Amanda Flory Renfro, PT, DPT
• Janet Renfro, RN
• Ashley Brooke Rennels, M.S. CCC-SLP
• Monica Reno, CNM

• Primary Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2022; 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.