Renaissance Wellness

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RENAISSANCE WELLNESS

Practice address

751 Thimble Shoals Blvd Ste M
Newport News, VA 23606-3563

Phone

(757) 782-2279

Fax

(757) 782-2313

NPI assigned

May 16, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Royster, PSY.D; PH.DNPI 1386365286

Title

Ceo/Director

Phone

(757) 782-2279

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Royster, PSYD

  • Community/Behavioral Health Agency
  • Newport News, VA
  • NPI 1386365286
  NPD Authorized official

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1356907182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 THIMBLE SHOALS BLVD STE M",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063563",
            "telephone_number": "757-782-2279",
            "fax_number": "757-782-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 THIMBLE SHOALS BLVD STE M",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063563",
            "telephone_number": "757-782-2279",
            "fax_number": "757-782-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "ROYSTER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "757-782-2279",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PSY.D; PH.D"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Renee Delahoussaye, M.D., P.C.
• Renew Life, LLC

• Community/Behavioral Health Agency in Newport News, VA
• Providers in Newport News, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.