Active NPI
Bryn Renda, PA-C., MCMSC
- Physician Assistant
- Kirkland, WA
National Provider Identifier
1124564588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9110059
- Practice address
- 10220 NE Points Dr
Kirkland, WA 98033-7864 - Phone
- (425) 410-4468
- NPI assigned
- Jan 10, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9110059 | FL | Primary |
Addresses
Primary practice location
10220 NE Points Dr
Kirkland, WA 98033-7864
Mailing address
850 19TH Ave N
St Petersburg, FL 33704-4244
Phone (407) 301-6004
Other practice location 1
10475 Gandy Blvd N Unit 1124
St Petersburg, FL 33702-2490
Phone (407) 301-6004
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9110059 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1124564588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 19TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337044244",
"telephone_number": "407-301-6004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10220 NE POINTS DR",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980337864",
"telephone_number": "425-410-4468"
}
],
"practiceLocations": [
{
"address_1": "10475 Gandy Blvd N Unit 1124",
"address_purpose": "LOCATION",
"city": "St Petersburg",
"state": "FL",
"postal_code": "337022490",
"country_code": "US",
"telephone_number": "407-301-6004",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RENDA",
"first_name": "BRYN",
"credential": "PA-C., MCMSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-10",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9110059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.