Justin Grant Stiltner Rennick, LSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

525 Metro PL N Ste 300
Dublin, OH 43017-5320

Phone

(855) 289-1722

NPI assigned

Dec 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

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.

• Phoenix Group Home, LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD (past)
• Phoenix Group Home, LLC

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD (past)

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1124624036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "855-289-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Ironton",
            "state": "OH",
            "postal_code": "456381502",
            "country_code": "US",
            "telephone_number": "740-532-1613",
            "fax_number": "740-879-0599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "567 Tanglewood Dr",
            "address_purpose": "LOCATION",
            "city": "Wheelersburg",
            "state": "OH",
            "postal_code": "456948342",
            "country_code": "US",
            "telephone_number": "740-776-8004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 Gallia St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456624139",
            "country_code": "US",
            "telephone_number": "740-529-2125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENNICK",
        "first_name": "JUSTIN",
        "middle_name": "GRANT STILTNER",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903291",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443564",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adison Elizabeth Rengert, DC
• Michael James Rengert, O.D.
• Susan Rengert
• Autumn Renick
• Briana Renner, RN
• Lyndsay Morgan Rennick
• Allison Renollet, PT, DPT
• Holly Rentz
• Michael John Repasky, DDS
• Danielle M Repko

• Case Manager/Care Coordinator in Dublin, OH
• Providers in Dublin, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.