Anew Genesis Wellness Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ANEW GENESIS WELLNESS INC.

Practice address

4205 Quailshire Arch
Chesapeake, VA 23321-3244

Phone

(757) 761-8686

NPI assigned

May 17, 2020

Last updated

May 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Renata Jamison, LCSWNPI 1043724602

Title

Ceo

Phone

(757) 761-8686

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Renata Jamison

  • Clinical Social Worker
  • Chesapeake, VA
  • NPI 1043724602
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1589673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589673600000",
    "number": "1407478084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 QUAILSHIRE ARCH",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213244",
            "telephone_number": "757-761-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 QUAILSHIRE ARCH",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213244",
            "telephone_number": "757-761-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANEW GENESIS WELLNESS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-17",
        "last_updated": "2020-05-17",
        "certification_date": "2020-05-17",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "RENATA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-761-8686",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.