Renew Spine and Rehab Inc

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

Legal business name

RENEW SPINE AND REHAB INC

Practice address

24725 W 12 Mile Rd Ste 260
Southfield, MI 48034-8310

Phone

(248) 353-2225

Fax

(248) 353-2239

NPI assigned

Feb 5, 2025

Organization subpart

No

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

Authorized official

Name

Morgan Glazer

Title

Coo

Phone

(248) 353-2225

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1861206153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24725 W 12 MILE RD STE 260",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348310",
            "telephone_number": "248-353-2225",
            "fax_number": "248-353-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24725 W 12 MILE RD STE 260",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348310",
            "telephone_number": "248-353-2225",
            "fax_number": "248-353-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW SPINE AND REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "GLAZER",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "248-353-2225"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Renew Rehabilitative Medicine
• Ricketa Reno
• Renovis Care Company
• Renovis Choice Company
• Renovis Health LLC
• Residential Physicians Association, PLLC

• Sports Medicine (Emergency Medicine) Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Sports Medicine (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.