Renew Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RENEW PSYCHIATRY LLC

Practice address

4656 Amber Valley Pkwy S
Fargo, ND 58104-4593

Phone

(701) 552-2325

NPI assigned

Aug 19, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Ugelstad, PMHNPNPI 1285373738

Title

Nurse Practitioner

Phone

(701) 251-0551

Specialties & licenses 1

Addresses

Other names 1

• Renew Psychiatry Doing business as

Locations

Practitioners 1

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

• Thomas Ugelstad, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fargo, ND
  • NPI 1285373738
  NPD Authorized official

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728777600000",
    "number": "1447082391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 PACIFIC DR S APT 301",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035547",
            "telephone_number": "701-251-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 AMBER VALLEY PKWY S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044593",
            "telephone_number": "701-552-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A",
        "authorized_official_last_name": "UGELSTAD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "701-251-0551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teresa Rene, OTR/L
• Thomas James Rene, OD
• Aaron Michael Renelt, D.C.
• Gabrielle Marie Renelt
• Renew Medical Clinic LLC
• Renewed Wellness and Ketamine Clinic
• Gary L Renier, O.D.
• Krista Rennecke
• Rachel May Renner, DPT
• Bonnie M Renschler-Greuel

• Psychiatric/Mental Health Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2024; 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.