Active NPI
David A Renne
- Audiologist
- Bellevue, WA
National Provider Identifier
1114974177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- LD00001946
- Practice address
- 1038 116TH Ave NE
Ste 330
Bellevue, WA 98004-4621 - Phone
- (425) 455-5596
- Fax
- (425) 451-3248
- NPI assigned
- May 27, 2006
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | LD00001946 | WA | Primary |
Addresses
Primary practice location
1038 116TH Ave NE
Ste 330
Bellevue, WA 98004-4621
Mailing address
5000 Cheshire Pkwy N
Plymouth, MN 55446-4103
Phone (888) 510-0766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8443871 | Medicaid | WA |
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 |
|---|---|---|---|
| LD00001946 | WA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairwood Hearing Care, PLLP | Audiologist | Current | Accepting new patients |
| Simply Hear | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Hearing Instrument Specialist
- Bremerton, WA
- NPI 1649608423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295568000000",
"number": "1114974177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 CHESHIRE PKWY N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554464103",
"telephone_number": "888-510-0766",
"fax_number": "763-268-4430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1038 116TH AVE NE",
"address_2": "STE 330",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980044621",
"telephone_number": "425-455-5596",
"fax_number": "425-451-3248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNE",
"first_name": "DAVID",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2011-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LD00001946",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8443871",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.