Renew Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RENEW PHYSICAL THERAPY, INC

Practice address

2701 Larsen Rd
Suite 111
Green Bay, WI 54303-4863

Phone

(920) 883-2284

NPI assigned

Mar 5, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Shawn E Jackson, DPT

Title

Physical Therapist

Phone

(920) 833-2284

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1639410434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 LARSEN RD",
            "address_2": "SUITE 111",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034863",
            "telephone_number": "920-883-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 LARSEN RD",
            "address_2": "SUITE 111",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034863",
            "telephone_number": "920-883-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "920-833-2284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Racine Elaine Locsin Reinoso, MD
• Relentless Advance LLC
• Renal Life Link Inc
• Renal Life Link Inc
• Susan Laverne Renard, COTA
• Thomas Renk, PMHNP
• David William Rentmeester, MD
• Deborah G Rentmeester, PT
• Hannah Rentmeester, AUD
• Michelle M Rentmeester, OT

• Physical Therapy Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.