NPIMap

Organization Active NPI

Renew Wound Care Center PLLC

  • General Practice Physician
  • Cornelius, NC
National Provider Identifier
1881419398
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
RENEW WOUND CARE CENTER PLLC
Practice address
18805 W Catawba Ave Ste 205a
Cornelius, NC 28031-4609
Phone
(704) 612-0011
NPI assigned
Nov 19, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Coral KirscherNPI 1659819001
Title
Owner
Phone
(704) 997-1260

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

18805 W Catawba Ave Ste 205a
Cornelius, NC 28031-4609

Mailing address

18805 W Catawba Ave Ste 205a
Cornelius, NC 28031-4609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250218000549 NC Part B Supplier - Clinic/Group Practice 6901326248 Receives reassigned benefits from 5 practitioners
Practice locations: Mount Airy, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1881419398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 205A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 205A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314609",
            "telephone_number": "704-612-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW WOUND CARE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "KIRSCHER",
        "authorized_official_first_name": "CORAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-997-1260"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.