NPIMap

Organization Active NPI

Renaissance Medical Group

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1740365121
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RENAISSANCE MEDICAL GROUP
Practice address
790 N Main St
Providence, RI 02904-5706
Phone
(401) 272-3600
Fax
(401) 272-3636
NPI assigned
Oct 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tarek Wehbe, M.D.NPI 1619925393
Title
Owner
Phone
(401) 455-3574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

790 N Main St
Providence, RI 02904-5706

Mailing address

790 N Main St
Providence, RI 02904-5706
Phone (401) 272-3600

National Provider Directory

National Provider Directory

Locations

790 N Main St
Providence, RI 02904
Phone (401) 455-3574

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740365121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045706",
            "telephone_number": "401-272-3600",
            "fax_number": "401-272-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045706",
            "telephone_number": "401-272-3600",
            "fax_number": "401-272-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEHBE",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-455-3574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.