Active NPI
Charles E Renner, OTR/CHT
- Occupational Therapist
- Springfield, MO
National Provider Identifier
1093847899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 000512
- Practice address
- 2017 W Woodland St
Springfield, MO 65807-5913 - Phone
- (417) 889-4800
- Fax
- (417) 889-0980
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 000512 | MO | Primary |
Addresses
Primary practice location
2017 W Woodland St
Springfield, MO 65807-5913
Mailing address
2017 W Woodland St
Springfield, MO 65807-5913
Phone (417) 889-4800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000512 | MO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384300800000",
"number": "1093847899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2017 W WOODLAND ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075913",
"telephone_number": "417-889-4800",
"fax_number": "417-889-0980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2017 W WOODLAND ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075913",
"telephone_number": "417-889-4800",
"fax_number": "417-889-0980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNER",
"first_name": "CHARLES",
"middle_name": "E",
"credential": "OTR/CHT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2013-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "000512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.