RENAISSANCE MEDICAL CENTER (NPI# 1649733387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649733387 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE MEDICAL CENTER |
| Other Organization Name | RENAISSANCE MEDICAL CARE |
| Practice Address |
284 Blevins Blvd Bristol VA 24202-5977 |
| Practice Telephone | 2762853911 |
| Mailing Telephone | 2762853911 |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-06-24 |
| Authorized Official Name | LINDA DEBORD (OFFICE MANAGER) |
| Authorized Official Telephone | 2762853911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 0101249115 | 05 |
| Other Name | Type Code |
|---|---|
| Renaissance Medical Care | Doing Business As Name - Organization |
| RMC | Other Name - Individual/Organization |
| Street Address |
284 BLEVINS BLVD |
| City | BRISTOL |
| State | VA |
| Zip Code | 24202-5977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780214049 | Tasha Nichole Herndon | Nurse Practitioner | 284 Blevins Blvd, Bristol, VA 24202-5977 | 2020-01-24 |
| 1821658451 | Christine Wright Mckenzie | Counselor | 284 Blevins Blvd, Bristol, VA 24202-5977 | 2019-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568977940 | Renaissance Medical Care | Family Medicine | 284 Blevins Boulevard, Bristol, VA 24202 | 2017-12-07 |
| 1467725879 | Leighton W Wood Dds Ms P.C. | Dentist | 103 Linden Square Drive, Bristol, VA 24202 | 2012-02-15 |
| 1285828640 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 13249 Lee Highway, Bristol, VA 24202 | 2007-08-29 |
| 1154462117 | Emdee Clinica, Pllc | Clinic/Center | 23164 Kestrel Dr, Bristol, VA 24202 | 2007-02-10 |
| 1053355859 | Commonweatlh of Virginia State Board of Health | Public Health or Welfare | 15068 Lee Highway, Suite 1000, Bristol, VA 24202 | 2006-06-15 |
| 1891775193 | William Daryl Wilson | Dentist | 15068 Lee Hwy, Ste 1000 Washington Co Health Dept, Bristol, VA 24202 | 2006-01-20 |
| 1457832123 | Justin Scott Pennington | Physical Therapist | 136 Bristol East Rd, Bristol, VA 24202 | 2018-08-22 |
| 1588104335 | Timothy G. Mcgarry, Md, Pllc | Orthopaedic Surgery | 21371 Forsythe Rd, Bristol, VA 24202 | 2017-02-27 |
| 1669532560 | Washington Co Health Dept Dental Clinic | Dentist | 15068 Lee Highway, Suite 1000, Bristol, VA 24202 | 2006-12-11 |
| 1437568946 | Family Preservation Services, Inc | Community/Behavioral Health | 7741 Rich Valley Rd, Bristol, VA 24202-0439 | 2014-08-08 |
| Find all providers in zip 24202 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659439172 | Neil Frances Mooney | General Practice | 2320 Volunteer Pkwy, Bristol, TN 37620 | 2006-12-05 |
| 1669407987 | Chin Lin Cheng | General Practice | 381 Suncrest Drive, Bristol, VA 24201-1831 | 2006-07-12 |
| 1770115578 | Foundations Integrated Medical & Sports Health, LLC | General Practice | 300 Moore St Ste B, Bristol, VA 24201-4495 | 2020-02-10 |
| 1649496209 | Levester Thompson | General Practice | 2195 Euclid Ave Ste 6, Bristol, VA 24201-3655 | 2007-04-18 |
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| 1407465289 | Martine H Long | General Practice | 515 Cornerstone St, Lynchburg, VA 24502-5342 | 2020-07-28 |
| 1720617525 | Squadron Health Enterprises, LLC | General Practice | 10602 Allenwood Ln, Great Falls, VA 22066-3229 | 2020-04-03 |
| 1851929558 | Medical Care for Family LLC | General Practice | 6408k Seven Corners Pl Ste G, Falls Church, VA 22044-2007 | 2020-03-29 |
| 1104389337 | Bardia Nemati | General Practice | 731 Walker Rd # E1, Great Falls, VA 22066-2834 | 2019-04-14 |
| 1174081707 | William Shannon | General Practice | 1751 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2019-03-02 |
| 1700367679 | Healthy Schools Virginia LLC | General Practice | 9603 Gayton Rd Ste 100, Richmond, VA 23238-4964 | 2018-08-28 |
| 1114414299 | Alliance Family Practice, Inc | General Practice | 119 W Brookland Park Blvd, Richmond, VA 23222-2633 | 2018-04-15 |
| 1093219131 | Virginia Advanced Medical LLC | General Practice | 300 Medical Pkwy Ste 306, Chesapeake, VA 23320-4985 | 2018-03-22 |
| 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.