NPIMap

Organization Active NPI

Reneu Physical Therapy LLC

Doing business as Reneu Sport and Health

  • Physical Therapy Clinic/Center
  • Wayzata, MN
National Provider Identifier
1861948739
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
8820 Issued in MN
Legal business name
RENEU PHYSICAL THERAPY LLC
Doing business as
Reneu Sport and Health
Practice address
101 Lake St W Ste 210
Wayzata, MN 55391-1578
Phone
(612) 562-6581
NPI assigned
Aug 30, 2016
Last updated
Jun 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Authorized official

Name
Natalie Marie Miller, PT, DPT, OCSNPI 1457639569
Title
Owner, PT
Phone
(612) 860-6525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 8820 MN Primary

Addresses

Primary practice location

101 Lake St W Ste 210
Wayzata, MN 55391-1578

Mailing address

2608 Clover Field Cir
Chaska, MN 55318-3233
Phone (612) 860-6525

Other names 1

  • Reneu Sport and Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161201000073 MN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4688954001 Receives reassigned benefits from 1 practitioner
Practice locations: Wayzata, MN

National Provider Directory

National Provider Directory

Locations

8401 Golden Valley Rd
Ste 301
Minneapolis, MN 55427
Phone (763) 544-1276

101 Lake St W
Ste 1210
Wayzata, MN 55391

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654300800000",
    "number": "1861948739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 CLOVER FIELD CIR",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553183233",
            "telephone_number": "612-860-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LAKE ST W STE 210",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911578",
            "telephone_number": "612-562-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEU PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "612-860-6525",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MN",
            "license": "8820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reneu Sport and Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; 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.