Individual provider Active NPI

Ronald Renard, PT

  • Physical Therapist
  • Marshall, MO
National Provider Identifier
1164591921
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
941 Cherokee Dr
Suite 2a
Marshall, MO 65340-3646
Phone
(660) 831-1895
Fax
(660) 831-1898
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

941 Cherokee Dr
Suite 2a
Marshall, MO 65340-3646

Mailing address

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone (573) 449-8771

Other identifiers 1

IdentifierTypeStateIssuer
101983OtherMOLICENSE#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070712000041 MO Practitioner - Physical Therapist in Private Practice 0042310666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

203 E 2ND St
Milan, MO 63556-1333
Phone (660) 265-3055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince Nov 1, 2014 Accepting new patients
Boone Physician Services, LLC CurrentSince Sep 28, 2023 Accepting new patients
Bothwell Regional Health Center PastSince Nov 1, 2014 Accepting new patients
BDM Associates LLC Physical Therapist Past Accepting new patients

Locations

603 S Henry Clay Blvd
Ste B
Ashland, MO 65010
Phone (573) 657-1915

1238 N Remington St
Centralia, MO 65240
Phone (573) 682-2230

3301 Berrywood Dr
Ste 2
Columbia, MO 65201
Phone (573) 449-8771

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

1605 E Broadway
Ste 300
Columbia, MO 65201
Phone (573) 256-7700

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

100 E Davis St
Fayette, MO 65248
Phone (660) 248-3053

1002 Diamond Rdg
Ste 800
Jefferson City, MO 65109
Phone (573) 761-9360

941 Cherokee Dr
Ste 2A
Marshall, MO 65340
Phone (660) 831-1895

203 E 2nd St
Milan, MO 63556
Phone (660) 265-3055

3222 W 16th St
Sedalia, MO 65301
Phone (660) 827-6800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1164591921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 CHEROKEE DR",
            "address_2": "SUITE 2A",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403646",
            "telephone_number": "660-831-1895",
            "fax_number": "660-831-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENARD",
        "first_name": "RONALD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "101983",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.