Rena Burlingame Rengo, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2008-00705 Issued in NC

Practice address

203 Indigo Dr
Brunswick, GA 31525-6865

Phone

(912) 261-2669

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southeastern Pathology Associates PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Brunswick, GA
  • NPI 1992963268
  NPD (past)

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1053591602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 INDIGO DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256865",
            "telephone_number": "912-261-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 INDIGO DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256865",
            "telephone_number": "912-261-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENGO",
        "first_name": "RENA",
        "middle_name": "BURLINGAME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2008-00705",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NC",
            "license": "2008-00705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "148U6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00445423",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909325",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Red River Homecare of the Golden Isles
• Johnnie Reed
• Regal Anesthesia, LLC
• Alexandra Reichenberg, DPT
• Renfred R. Halverson DC., P.C.
• John R Rentz, MD
• Turner W. Rentz Jr., M.D.
• Renue Plastic Surgery, LLC
• Renue Surgery Center LLC
• Beth Respess, PA

• Anatomic Pathology & Clinical Pathology Physician in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.