Renovo Wellness, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RENOVO WELLNESS, LLC

Practice address

10771 Perkins Rd Ste C
Baton Rouge, LA 70810-1693

Phone

(225) 256-1634

Fax

(225) 384-5402

NPI assigned

Apr 17, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Donald W Pope Jr.

Title

Administrator

Phone

(225) 256-1634

Specialties & licenses 4

Addresses

Other names 1

• Renovo Wellness Doing business as

Locations

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1801416060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10771 PERKINS RD STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101693",
            "telephone_number": "225-256-1634",
            "fax_number": "225-384-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10771 PERKINS RD STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101693",
            "telephone_number": "225-256-1634",
            "fax_number": "225-384-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVO WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-256-1634",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renovo Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renovo Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.