Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Renew Wellness Inc

Organization Family Medicine Physician · NPI 1053779058

Renew Wellness Inc is a Family Medicine Physician in Hampton, Georgia. Licensed in Georgia. Registered with an NPI since 2016.

Licensed in
GA
In the registry since
2016
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11348 Tara Blvd Ste 100
Hampton, GA 30228-6277
Phone: (678) 466-6424
Fax: (678) 466-6464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 048349 (GA)

Record details

NPI number1053779058
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stacy Petit — Owner · (678) 615-4029
NPI enumeratedFebruary 4, 2016
Last updated in NPPESFebruary 4, 2016
Mailing address11348 Tara Blvd, Ste 100, Hampton, GA 30228-6277

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