Active NPI
Elizabeth Rende
- Pediatrics Physician
- Saint Cloud, MN
National Provider Identifier
1003979881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 6361
- Practice address
- 1200 6TH Ave N
Saint Cloud, MN 56303 - Phone
- (320) 251-2700
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 6361 | MN | |
| Pediatrics Physician | 208000000X | 6361 | MN | Primary |
Addresses
Primary practice location
1200 6TH Ave N
Saint Cloud, MN 56303
Mailing address
28 13TH St S
Sauk Rapids, MN 56379-1065
Phone (919) 698-2030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190415000049 | MN | Practitioner - Nurse Practitioner | 7416905666 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557705600000",
"number": "1003979881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 13TH ST S",
"city": "SAUK RAPIDS",
"state": "MN",
"postal_code": "563791065",
"telephone_number": "919-698-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-251-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDE",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2019-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MN",
"license": "6361",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "6361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.