Renew Physical Therapy and Wellness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RENEW PHYSICAL THERAPY AND WELLNESS LLC

Practice address

424 Gentian Rd
St Augustine, FL 32086-6426

Phone

(904) 599-5459

NPI assigned

Mar 21, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Rieder, DPT

Title

Owner

Phone

(904) 599-5459

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1972205003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 GENTIAN RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866426",
            "telephone_number": "904-599-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 GENTIAN RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866426",
            "telephone_number": "904-599-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PHYSICAL THERAPY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "RIEDER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-599-5459",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Reigel, PHARMD.
• Michelle Renee Reillo, RN, NP, PHD
• Melissa Ann Reimert, PT, OTR/L, DPT, MOT
• Relyon Chiropractic and Rehab Inc
• Remedy Physiorooms LLC
• Renew Therapy Partners Inc
• Rennigade Dental Group PLLC
• Angela Maria Restivo, LMT
• Restore Community Counseling
• Luke Jared Retherford, OTR/L

• Physical Therapy Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.