RENU MEDISPA (NPI# 1407129125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407129125 |
| Entity Type | Organization |
| Organization Name | RENU MEDISPA |
| Practice Address |
951 E Plaza Dr Suite 150 Eagle ID 83616-6566 |
| Practice Telephone | 2089394456 |
| Practice Fax Number | 2082872200 |
| Mailing Telephone | 2089394456 |
| Mailing Fax Number | 2082872200 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-04-30 |
| Authorized Official Name | MS. TAWNI WEAVER (DIRECTOR) |
| Authorized Official Telephone | 2089394456 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | NP784A | ID | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | RENU MEDISPA LLC | 900 Rte. 376, Ste. H, Wappingers Falls, New York 12590 |
| Street Address |
951 E PLAZA DR SUITE 150 |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-6566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386643146 | Cynthia Ray Culp | Nurse Practitioner | 951 E Plaza Dr, Suite Number 110, Eagle, ID 83616-6566 | 2005-07-14 |
| 1356985816 | Synergy Health and Wellness | Chiropractor | 951 E Plaza Dr, Eagle, ID 83616-6566 | 2019-10-29 |
| 1528427796 | Danielle Sutton | Nurse Practitioner | 951 E Plaza Dr, #170, Eagle, ID 83616-6566 | 2016-02-16 |
| 1912270661 | Metabolic Health and Longevity Center | Clinic/Center | 951 E Plaza Dr, Suite 150, Eagle, ID 83616-6566 | 2012-02-10 |
| 1114227246 | Specialty Labs Pllc | Clinical Medical Laboratory | 951 E Plaza Dr, Suite 170, Eagle, ID 83616 | 2010-10-22 |
| 1144469735 | Claudia Parcells | Nurse Practitioner | 951 E Plaza Dr, Suite 170, Eagle, ID 83616-6566 | 2009-02-05 |
| 1104983881 | Rocky Mountain Health and Wellness LLC | Nurse Practitioner | 951 E Plaza Dr, Ste 110, Eagle, ID 83616-6566 | 2007-01-02 |
| 1891730917 | Tamara Marie Simon | Obstetrics & Gynecology | 951 E Plaza Dr, Suite 170, Eagle, ID 83616-6566 | 2006-06-20 |
| 1649237140 | Karen Angela Howell | Physical Therapist | 951 E Plaza Dr, Eagle, ID 83616-6566 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518214345 | Diabetes Dynamics | Clinic/Center | 9 Rt. Ladybelle Pl, Box 5620, Eagle, CO 81631-5620 | 2012-08-10 |
| 1720188857 | Eagle Chiropractic PC | Clinic/Center | 5337 S State St, Eagle, ID 83616-4313 | 2006-09-25 |
| 1174170427 | Vail Clinic, Inc. | Clinic/Center | 377 Sylvan Lake Road, Eagle, CO 81631 | 2019-08-21 |
| 1700399359 | Caring Edge Op LLC | Clinic/Center | 77 N Fisher Park Way, Eagle, ID 83616 | 2017-11-06 |
| 1760768428 | Healthy Alignment Chiropractic Pllc | Clinic/Center | 742 E State St Ste 150, Eagle, ID 83616-5941 | 2011-10-26 |
| 1972757870 | University Professional Services | Clinic/Center | 3101 E State St, Suite 2107, Eagle, ID 83616-6232 | 2008-11-05 |
| 1336327923 | Gregory L. Flint M.d., P.C. | Clinic/Center | 868 E Riverside Dr, Suite 200, Eagle, ID 83616-6019 | 2008-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992323216 | Wolf Pack LLC | Clinic/Center | 939 S 25th E Ste 115, Ammon, ID 83406-5736 | 2020-07-13 |
| 1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
| 1164072187 | Peter John Leichtnam | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-12 |
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
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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.