Renewed Hope Health & Wellness, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RENEWED HOPE HEALTH & WELLNESS, LLC

Practice address

191 SE Broad St
Jesup, GA 31546-4628

Phone

(912) 559-2710

Fax

(912) 216-3672

NPI assigned

Jul 2, 2024

Organization subpart

No

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

Authorized official

Name

Mandy Diane Hubbard, NPNPI 1740425479

Title

President

Phone

(912) 223-5970

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mandy D. Brinson Hubbard, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jesup, GA
  • NPI 1740425479
  Medicare reassignment Authorized official
• Jessica Kate Clark, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Waycross, GA
  • NPI 1417412917
  Medicare reassignment NPD

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1740026541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 FORREST COVE DR",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315462144",
            "telephone_number": "912-559-2710",
            "fax_number": "912-216-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 SE BROAD ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315464628",
            "telephone_number": "912-559-2710",
            "fax_number": "912-216-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED HOPE HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-223-5970",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Jesup, GA
• Providers in Jesup, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.