Renew Medical Clinic LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

44547 Issued in MN

Legal business name

RENEW MEDICAL CLINIC LLC

Practice address

4225 38TH St S Ste 101
Fargo, ND 58104-7573

Phone

(701) 404-9909

Fax

(877) 813-3081

NPI assigned

Jan 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. David Jerome Hanson, MDNPI 1932262474

Title

Owner

Phone

(218) 770-1006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 4

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

• David Jerome Hanson, MD

  • Anesthesiology Physician
  • Fargo, ND
  • NPI 1932262474
  Medicare reassignment Authorized official
• Sarah Ann Connell, LPC

  • Professional Counselor
  • Moorhead, MN
  • NPI 1699315838
  NPD (past)
• Anika Lauren Walstrom, M.ED., LPCC

  • Professional Counselor
  • Moorhead, MN
  • NPI 1558106948
  NPD (past)
• Danielle Weller

  • Professional Counselor
  • Moorhead, MN
  • NPI 1720945983
  NPD (past)

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1811234032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 38TH ST S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047573",
            "telephone_number": "701-404-9909",
            "fax_number": "877-813-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 38TH ST S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047573",
            "telephone_number": "701-404-9909",
            "fax_number": "877-813-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-770-1006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MN",
            "license": "44547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yongsheng Ren, MD
• Teresa Rene, OTR/L
• Thomas James Rene, OD
• Aaron Michael Renelt, D.C.
• Gabrielle Marie Renelt
• Renew Psychiatry LLC
• Renewed Wellness and Ketamine Clinic
• Gary L Renier, O.D.
• Krista Rennecke
• Rachel May Renner, DPT

• Pain Medicine (Anesthesiology) Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Pain Medicine (Anesthesiology) Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.