Renew Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

RENEW PHYSICAL THERAPY, LLC

Practice address

19345 Sunshine Avenue
Covington, LA 70433

Phone

(985) 809-3940

Fax

(985) 809-3942

NPI assigned

Aug 10, 2007

Last updated

Apr 6, 2011By 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

Mr. Victor J Varisco, O.T.

Title

Managing Member

Phone

(337) 233-7701

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 10

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.

• Gabrielle Alter, PT, DPT

  • Orthopedic Physical Therapist
  • Slidell, LA
  • NPI 1578011730
  Medicare reassignment Care Compare group NPD
• Mark T Cheralla, MPT, LOTR

  • Occupational Therapist
  • Baton Rouge, LA
  • NPI 1083647127

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Jason King, PT

  • Physical Therapist
  • Slidell, LA
  • NPI 1659349769
  Medicare reassignment Care Compare group NPD
• Karlie Rae McDougall, P.T., DPT

  • Physical Therapist
  • Covington, LA
  • NPI 1528244803
  Medicare reassignment Care Compare group NPD
• Conner Lynn Scheuermann, PT

  • Physical Therapist
  • Covington, LA
  • NPI 1639770613
  Medicare reassignment Care Compare group NPD
• Taylor Drude Archote, PT, DPT

  • Physical Therapist
  • Covington, LA
  • NPI 1649881459
  Medicare reassignment NPD
• Kyle Babin, DPT

  • Physical Therapist
  • Broussard, LA
  • NPI 1891127114
  Medicare reassignment NPD
• Dawn Pittman Holliday, PT

  • Physical Therapist
  • Covington, LA
  • NPI 1528134731
  Medicare reassignment NPD
• Kerry Lamkin, P.T.

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1497728463
  Medicare reassignment NPD
• Christopher Wayne McDougall, DPT

  • Physical Therapist
  • Indialantic, FL
  • NPI 1639321862
  NPD

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1699967992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19345 SUNSHINE AVENUE",
            "address_2": "SUITE A",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338720",
            "telephone_number": "985-809-3940",
            "fax_number": "985-809-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19345 SUNSHINE AVENUE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70433",
            "telephone_number": "985-809-3940",
            "fax_number": "985-809-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "VARISCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "337-233-7701",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Reitan, LMSW
• Taylor Reitz, LCSW
• Michael Stephen Relle, CPO
• Remed Recovery Care Centers of Louisiana LLC
• Renal Treatment Centers-Southeast, LP. (Dialysis Systems of Covington)
• Renewal and Restoration, LLC (Renewal and Restoration, LLC Therapeutic and Counseling Services)
• Lorenzo Resendez Jr.
• Dawn Rester, LOTR
• Reviving Minds LLC
• Kerri W Reynolds

• Physical Therapist in Covington, LA
• Providers in Covington, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.