Organization Active NPI

Renaissance Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Frankfort, KY
National Provider Identifier
1841419926
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
RENAISSANCE MEDICAL LLC
Practice address
1006 Leawood Dr
Ste 201
Frankfort, KY 40601-3349
Phone
(502) 227-7422
Fax
(502) 227-7424
NPI assigned
Apr 25, 2007
Last updated
Jun 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Authorized official

Name
Mr. James C Graham
Title
President
Phone
(606) 878-0453

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU

Addresses

Primary practice location

1006 Leawood Dr
Ste 201
Frankfort, KY 40601-3349

Mailing address

1380 W 5TH St
London, KY 40741-1615
Phone (606) 878-0453

Other identifiers 1

IdentifierTypeStateIssuer
7100205870MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930023847 KY DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 3971624560 Practice locations: Frankfort, KY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Renaissance Medical LLC1006 Leawood Dr, Frankfort, KY 40601-3523(502) 227-7422 Commodes, Urinals, Bedpans|Hospital Beds (Electric)|Hospital Beds (Manual)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Wheelchair Seating/Cushions|Tracheotomy Supplies|Continuous Positive Airway Pressure … Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Medical LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1006 Leawood Dr
Ste 201
Frankfort, KY 40601
Phone (502) 227-7422

1380 W 5th St
London, KY 40741
Phone (606) 878-0453

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1841419926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 W 5TH ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411615",
            "telephone_number": "606-878-0453",
            "fax_number": "606-878-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 LEAWOOD DR",
            "address_2": "STE 201",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406013349",
            "telephone_number": "502-227-7422",
            "fax_number": "502-227-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-878-0453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100205870",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.