Renew Health South

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

RENEW HEALTH SOUTH

Practice address

6406 Carmel Rd Ste 304
Charlotte, NC 28226-8267

Phone

(704) 541-6000

Fax

(704) 541-3350

NPI assigned

Jul 6, 2021

Organization subpart

No

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

Authorized official

Name

Micah Kirscher

Title

Owner

Phone

(704) 310-1175

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1619548237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 CARMEL RD STE 304",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268267",
            "telephone_number": "704-541-6000",
            "fax_number": "704-541-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 CARMEL RD STE 304",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268267",
            "telephone_number": "704-541-6000",
            "fax_number": "704-541-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW HEALTH SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "KIRSCHER",
        "authorized_official_first_name": "MICAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-310-1175"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefan Renaud, D.O.
• Nina Renders
• Jahaziel Rendon, PA
• Renee Beauregard, PLLC
• Renew 360 Support Services Inc
• Renew Project LLC
• Renew Support Services PLLC
• Renewed & Restored LLC
• Renewed Axis Telehealth PLLC
• Renewed Beginnings Home Inc

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.