Active NPI
Ronald Leslie Rennick, M.D.
- Student Health Clinic/Center
- Eugene, OR
National Provider Identifier
1114998309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student Health Clinic/Center
- License
- 10449
- Practice address
- 1232 University of Oregon
Eugene, OR 97403-1232 - Phone
- (541) 346-0565
- Fax
- (541) 346-2748
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student Health Clinic/Center | 261QS1000X | 10449 | OR | Primary |
Addresses
Primary practice location
1232 University of Oregon
Eugene, OR 97403-1232
Mailing address
1232 University of Oregon
Eugene, OR 97403-1205
Phone (541) 346-0565
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217562 | Medicaid | OR | |
| 930026495 | Other | OR | RAILROAD MEDICARE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10449 | OR | MD | Student Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1114998309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1232 UNIVERSITY OF OREGON",
"city": "EUGENE",
"state": "OR",
"postal_code": "974031205",
"telephone_number": "541-346-0565",
"fax_number": "541-346-2748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1232 UNIVERSITY OF OREGON",
"city": "EUGENE",
"state": "OR",
"postal_code": "974031232",
"telephone_number": "541-346-0565",
"fax_number": "541-346-2748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNICK",
"first_name": "RONALD",
"middle_name": "LESLIE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "261QS1000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Student Health",
"state": "OR",
"license": "10449",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "217562",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "930026495",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.