RENOVUS MEDICAL SPA (NPI# 1134408214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134408214 |
| Entity Type | Organization |
| Organization Name | RENOVUS MEDICAL SPA |
| Practice Address |
405 Roy Martin Rd Ste 104 Gray TN 37615-2551 |
| Practice Telephone | 4232070154 |
| Mailing Telephone | 4232070154 |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-08-08 |
| Authorized Official Name | KATHY BEARD (OWNER) |
| Authorized Official Telephone | 4232070154 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 17509 | TN | Managed Care Organizations |
| Street Address |
405 ROY MARTIN RD STE 104 |
| City | GRAY |
| State | TN |
| Zip Code | 37615-2551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417242710 | Kathy Beard | Specialist | 405 Roy Martin Rd, Ste 104, Gray, TN 37615-2551 | 2011-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
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| 1821617671 | Master Remodelers LLC | Point of Service | 10820 Kingston Pike Ste 5, Knoxville, TN 37934-3065 | 2020-04-13 |
| 1477089910 | Laser Aesthetics Body and Wellness | Point of Service | 9755 Highway 64, Suite 101, Arlington, TN 38002-8579 | 2017-05-03 |
| 1518499771 | Tuesday and Company, Inc. | Point of Service | 502 N Garden St, Suite 104, Columbia, TN 38401-3238 | 2017-03-28 |
| 1134673437 | Dearing Physical Medicine | Point of Service | 201 Rosa Helm Way, Franklin, TN 37067-8408 | 2016-08-04 |
| 1386008753 | Spirit of Service Counseling & Wellness Center, LLC | Point of Service | 3568 Kearney Ave, Memphis, TN 38111-5743 | 2016-04-11 |
| 1093110546 | Blessed Homecare LLC | Point of Service | 219 Evergreen Cir, Hendersonville, TN 37075-2944 | 2014-10-27 |
| 1265854947 | Parker & Parker Dds Pa | Point of Service | 111 S Weisgarber Rd, Knoxville, TN 37919-4928 | 2014-01-14 |
| 1891131801 | Northcliff, Aclf | Point of Service | 14691 Highway 22 N, Lexington, TN 38351-4825 | 2013-05-16 |
| 1508106741 | Vick Partners LLC | Point of Service | 905 Hamlet Dr, Murfreesboro, TN 37128-5297 | 2013-02-25 |
| 1174884746 | Omni Home Health | Point of Service | 510 Hospital Dr Ste 101, Madison, TN 37115-5033 | 2012-05-31 |
| 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.