RENUVA XTREMITY LLC NPI 1205305430

NPI Information

  • NPI: 1205305430
  • Provider Name: RENUVA XTREMITY, LLC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 2900 KIRBY PKWY
    STE 5
    MEMPHIS, TN
    ZIP 38119
  • Phone: (901) 309-8898

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NPI Details

RENUVA XTREMITY, LLC is a foot and ankle surgery podiatrist in Memphis, TN. RENUVA XTREMITY, LLC NPI is 1205305430. The provider is registered as an organization entity type.

The provider's business location address is:

2900 KIRBY PKWY
STE 5
MEMPHIS, TN
ZIP 38119
Phone: (901) 309-8898
Fax: (901) 309-5908

The provider's authorized official is Nathan Lucas .
The authorized official title is Podiatrist and has the following contact phone number (901) 309-8898.

The enumeration date for this NPI number is 11/16/2018 and was last updated on 4/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2000XClinic/CenterPhysical TherapyNo
2291U00000XClinical Medical LaboratoryNo
3293D00000XPhysiological LaboratoryNo
4332B00000XDurable Medical Equipment & Medical SuppliesNo
5335E00000XProsthetic/Orthotic SupplierNo
6213ES0103XPodiatristFoot & Ankle SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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