Individual provider Active NPI

Jennifer Ann-Gabrys Rench, MD

  • Family Medicine Physician
  • Plymouth, WI
National Provider Identifier
1013090455
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1734 Issued in WI
Practice address
825 Walton Dr
Plymouth, WI 53073-5022
Phone
(920) 893-4322
Fax
(920) 893-9506
NPI assigned
Oct 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1734 WI Primary

Addresses

Primary practice location

825 Walton Dr
Plymouth, WI 53073-5022

Mailing address

825 Walton Dr
Plymouth, WI 53073-5022
Phone (920) 496-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090427000354 WI Practitioner - Family Practice 8628126893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jan 1, 2010 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jan 1, 2010 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Current Accepting new patients

Locations

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

830 E Green Bay Ave
Saukville, WI 53080
Phone (262) 284-7117

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1013090455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WALTON DR",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530735022",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WALTON DR",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530735022",
            "telephone_number": "920-893-4322",
            "fax_number": "920-893-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENCH",
        "first_name": "JENNIFER",
        "middle_name": "ANN-GABRYS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "1734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

Verify at the official NPI Registry.