Renew Psychiatric Associates, PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RENEW PSYCHIATRIC ASSOCIATES, PLLC

Practice address

12701 W State Highway 29 Ste 5
Liberty Hill, TX 78642-6348

Phone

(512) 548-5373

Fax

(512) 548-5374

NPI assigned

Apr 17, 2019

Organization subpart

No

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

Authorized official

Name

Anastasia Corker, PMHNP

Title

Owner

Phone

(512) 876-7037

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1700449402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 W STATE HIGHWAY 29 STE 5",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786426348",
            "telephone_number": "512-548-5373",
            "fax_number": "512-548-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 W STATE HIGHWAY 29 STE 5",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786426348",
            "telephone_number": "512-548-5373",
            "fax_number": "512-548-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PSYCHIATRIC ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "CORKER",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-876-7037",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558701565",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.