NPIMap

Organization Active NPI

Renue 018 Tawas, LLC

  • Physical Therapy Clinic/Center
  • Tawas City, MI
National Provider Identifier
1790452043
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RENUE 018 TAWAS, LLC
Practice address
540 W Lake St Ste 3
Tawas City, MI 48763-5101
Phone
(989) 984-6075
Fax
(989) 305-6038
NPI assigned
Aug 25, 2021
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Anthony Klapish
Title
Ceo
Phone
(989) 450-3341

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

540 W Lake St Ste 3
Tawas City, MI 48763-5101

Mailing address

804 N Water St
Bay City, MI 48708-5620
Phone (989) 450-3341

Other practice location 1

4431 N US 23
Oscoda, MI 48750-8801
Phone (989) 254-6455

Other practice location 2

401 E Huron Rd
Au Gres, MI 48703-9356
Phone (989) 450-3341 ext. 16

Other identifiers 1

IdentifierTypeStateIssuer
1790452043MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211021003168 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759779853 Receives reassigned benefits from 47 practitioners
Practice locations: Au Gres, MI; Oscoda, MI; Tawas City, MI

National Provider Directory

National Provider Directory

Locations

4431 N US Highway 23
Oscoda, MI 48750
Phone (989) 254-6455

540 W Lake St
Ste 3
Tawas City, MI 48763
Phone (989) 984-6075

Practitioners & affiliated clinicians

Practitioners 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1790452043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 N WATER ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487085620",
            "telephone_number": "989-450-3341",
            "fax_number": "989-778-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W LAKE ST STE 3",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487635101",
            "telephone_number": "989-984-6075",
            "fax_number": "989-305-6038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4431 N US 23",
            "address_purpose": "LOCATION",
            "city": "Oscoda",
            "state": "MI",
            "postal_code": "487508801",
            "country_code": "US",
            "telephone_number": "989-254-6455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E Huron Rd",
            "address_purpose": "LOCATION",
            "city": "Au Gres",
            "state": "MI",
            "postal_code": "487039356",
            "country_code": "US",
            "telephone_number": "989-450-3341 x16",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENUE 018 TAWAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "KLAPISH",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-450-3341"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790452043",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tawas City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.