N.K. Renaud, M.D. P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101231439 Issued in VA

Legal business name

N.K. RENAUD, M.D. P.C.

Practice address

2805 Columbia Pike
Suite B
Arlington, VA 22204-4411

Phone

(703) 486-3991

NPI assigned

Jul 1, 2008

Last updated

Jul 1, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nicole Kyongnan Renaud, M.D.NPI 1134190556

Title

President

Phone

(703) 486-3991

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Kyongnan Renaud, M.D.

  • Ophthalmology Physician
  • Arlington, VA
  • NPI 1134190556

  DC

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1003078924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 N ADAMS ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013409",
            "telephone_number": "703-486-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 COLUMBIA PIKE",
            "address_2": "SUITE B",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222044411",
            "telephone_number": "703-486-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N.K. RENAUD, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "RENAUD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "KYONGNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-486-3991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101231439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Arlington, VA
• Providers in Arlington, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.