Renuva Health LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

RENUVA HEALTH LLC

Doing business as

RENUVA BACK AND PAIN CENTER

Practice address

4400 College Blvd Ste 150
Overland Park, KS 66211-2326

Phone

(913) 667-2298

NPI assigned

May 16, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Michael Green, D.C.NPI 1164781795

Title

Associate D.C.

Phone

(913) 667-2829

Specialties & licenses 3

Addresses

Other names 1

• RENUVA BACK AND PAIN CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in KS2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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

• Valentina Picasso Almaraz, NP

  • Nurse Practitioner
  • Overland Park, KS
  • NPI 1386419588
  Medicare reassignment Care Compare group NPD
• Kelly Lynn Gonzalez, APRN

  • Family Medicine Physician
  • Leawood, KS
  • NPI 1295127363
  Medicare reassignment Care Compare group NPD
• Michael Green, D.C

  • Chiropractor
  • Overland Park, KS
  • NPI 1164781795
  NPD (past) Authorized official

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1801155486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 COLLEGE BLVD STE 150",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112326",
            "telephone_number": "913-667-2298",
            "fax_number": "816-525-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 COLLEGE BLVD STE 150",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112326",
            "telephone_number": "913-667-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENUVA HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSOCIATE D.C.",
        "authorized_official_telephone_number": "913-667-2829",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RENUVA BACK AND PAIN CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RENUVA BACK AND PAIN CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nurse Practitioner in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.