Renae Mary Altenhofen, RN CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

126027 Issued in MO

Practice address

2401 Gillham Rd
Kansas City, MO 64108-4619

Phone

(913) 696-8905

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1043262157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 69TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641131937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "913-696-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTENHOFEN",
        "first_name": "RENAE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "126027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429663701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Machen Alsop, MD
• Johnette Alston
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• Stephanie Michelle Altenburg, D.D.S.
• Timothy Joseph Altenburg, D.D.S
• Alter Services, Inc.
• Alternative Care Providers, LLC
• Alternative Opportunities, Inc.
• Alternative Opportunities, Inc.
• Alternative Opportunities, Inc.

• All providers in Kansas City, MO
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.