Renaissance Rehab

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-843 Issued in ID

Legal business name

RENAISSANCE REHAB

Practice address

4846 Wind River Rd
Idaho Falls, ID 83401-5828

Phone

(208) 339-7234

Fax

(208) 552-0395

NPI assigned

Sep 27, 2014

Organization subpart

No

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

Authorized official

Name

Mr. James A King, MS, OTR/LNPI 1538355532

Title

Owner

Phone

(208) 339-7234

Specialties & licenses 2

Addresses

Practitioners 1

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

• James Albert King, MS, OTR/L

  • Pediatric Occupational Therapist
  • Idaho Falls, ID
  • NPI 1538355532
  NPD (past) Authorized official

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411776000000",
    "number": "1821491424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4846 WIND RIVER RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015828",
            "telephone_number": "208-339-7234",
            "fax_number": "208-552-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4846 WIND RIVER RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015828",
            "telephone_number": "208-339-7234",
            "fax_number": "208-552-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-27",
        "last_updated": "2014-09-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-339-7234",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1398",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Johnson Reiss, LSW
• Reliance Mental Health
• Reliance Mental Health PC
• Kim Schultz Remien, NP
• Renaissance Ranch
• Rencher Family Practice, PA
• Mark B Rencher, MD
• Nathan S Rencher, D.O.
• Renewed Foundations LLC
• James Resare, LPC

• Occupational Therapist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; 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.