RENAISSANCE RECONSTRUCTIVE & PLASTIC SURGERY, PA (NPI# 1285671859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285671859 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE RECONSTRUCTIVE & PLASTIC SURGERY, PA |
| Practice Address |
2800 Blue Ridge Rd Suite 403 Raleigh NC 27607-6478 |
| Mailing Address |
Po Box 16576 Chapel Hill NC 27516-6576 |
| Practice Telephone | 9192320050 |
| Practice Fax Number | 9192320060 |
| Mailing Telephone | 9199676646 |
| Mailing Fax Number | 9199676647 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KEELEE JOY MACPHEE (PRESIDENT) |
| Authorized Official Telephone | 9192320050 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS/BLUE SHIELD | 140PM | 01 |
| NC | 5901014 | 05 |
| Street Address |
2800 BLUE RIDGE RD SUITE 403 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255335147 | Woodward Cannon | Surgery | 2800 Blue Ridge Rd, Ste 503, Raleigh, NC 27607-6477 | 2005-06-08 |
| 1134614050 | Shannon Dorothy Couture | Nurse Practitioner | 2800 Blue Ridge Rd, Raleigh, NC 27607 | 2018-06-23 |
| 1043703523 | Meredith Leigh Shillinglaw | Physician Assistant | 2800 Blue Ridge Rd, Raleigh, NC 27607 | 2018-06-11 |
| 1730629296 | Linh Thuc Nguyen | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 | 2017-03-03 |
| 1700320595 | Kathryn Star Salisbury | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 | 2016-12-13 |
| 1336598952 | Melissa Jennings Lunsford | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 300, Raleigh, NC 27607-6478 | 2016-06-04 |
| 1821479213 | Jessica Wrench | Nurse Practitioner | 2800 Blue Ridge Rd, Raleigh, NC 27607-6478 | 2015-06-11 |
| 1255720801 | Karen Monger | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 204, Raleigh, NC 27607-6478 | 2015-01-21 |
| 1811385776 | Keith Wesley Roberts | Physician Assistant | 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 | 2014-12-30 |
| 1912338054 | Rex Hospital Inc | Surgery | 2800 Blue Ridge Rd, Suite 300, Raleigh, NC 27607-6478 | 2013-11-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457983116 | North Raleigh Plastic Surgery, Pa | Plastic Surgery | 9104 Falls of Neuse Rd Ste 204, Raleigh, NC 27615-2494 | 2020-02-10 |
| 1841384567 | Christopher J Morea | Plastic Surgery | 7700 Lead Mine Rd, Raleigh, NC 27615-4828 | 2006-10-03 |
| 1831587435 | Glow Plastic Surgery, PC | Plastic Surgery | 10010 Falls of Neuse Rd, Suite 102, Raleigh, NC 27614-8494 | 2015-01-05 |
| 1245566090 | Lambeth Plastic Surgery & Aesthetics, Pa | Plastic Surgery | 4201 Lake Boone Trl, Ste 103, Raleigh, NC 27607-7512 | 2009-10-29 |
| 1679730907 | Matthew West Blanton | Plastic Surgery | 3633 Harden Rd, Suite 200, Raleigh, NC 27607-3369 | 2008-05-22 |
| 1245410901 | Jeremy W Pyle | Plastic Surgery | 2304 Wesvill Ct, Suite 360, Raleigh, NC 27607-2973 | 2007-11-11 |
| 1932312592 | Collins & Franklin Plastic Surgery | Plastic Surgery | 8300 Health Park, Ste 205, Raleigh, NC 27615-4731 | 2007-05-08 |
| 1891732558 | Keelee Joy Macphee | Plastic Surgery | 4414 Lake Boone Trl, Suite 407, Raleigh, NC 27607-7513 | 2006-06-01 |
| 1972575850 | Cynthia Lyn Diehl | Plastic Surgery | 10208 Cerny St, Suite 204, Raleigh, NC 27617-7884 | 2006-02-03 |
| 1710958004 | Roger Stewart Collins | Plastic Surgery | 8300 Health Park, Ste 205, Raleigh, NC 27615-4731 | 2006-01-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.