Michael Renfro, AT-C, MA

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1517 Issued in SC

Practice address

5701 Stillwater Blvd N
Oak Park Heights, MN 55082-1030

Phone

(651) 351-8034

NPI assigned

Jul 17, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1073920559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 COLONIAL DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161938",
            "telephone_number": "727-776-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 STILLWATER BLVD N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550821030",
            "telephone_number": "651-351-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFRO",
        "first_name": "MICHAEL",
        "credential": "AT-C, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Oak Park Heights, MN
• Providers in Oak Park Heights, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.