Renewal Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

16E991 Issued in CO

Legal business name

RENEWAL SURGERY CENTER, LLC

Practice address

9777 S Yosemite St Ste 210
Lone Tree, CO 80124-3115

Phone

(303) 708-2943

Fax

(720) 475-8485

NPI assigned

Apr 7, 2009

Organization subpart

No

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

Authorized official

Name

Stacy Duchane

Title

Administrator

Phone

(720) 475-8412

Specialties & licenses 1

Addresses

Other names 1

• Yosemite Street Surgery Center, LLC Former legal business name

Tax ID family

Renewal Surgery Center 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.

• Yosemite Street Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lone Tree, CO
  • NPI 1083893499
  NPD tax ID

Locations

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1508009564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 S YOSEMITE ST STE 210",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801243115",
            "telephone_number": "303-708-2943",
            "fax_number": "720-475-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 S YOSEMITE ST STE 210",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801243115",
            "telephone_number": "303-708-2943",
            "fax_number": "720-475-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "DUCHANE",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "720-475-8412"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CO",
            "license": "16E991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yosemite Street Surgery Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hannah Alexander Rector, DO
• Mia Recupito, MD
• Ryan Paul Reichert, DO
• Jarrod Reida, RN
• McKenzie Sue Reifschneider, DC
• Michael Renta, DPT
• Restoration Spine & Joint, PLLC
• Matthew Reynolds, DO
• Ross A Reynolds, PA-C
• Thomas Everett Reynolds, D.O.

• Ambulatory Surgical Clinic/Center in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Ambulatory Surgical Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.