Active NPI
John Scott Renes, PHARMACIST
- Pharmacist
- Shawnee, OK
National Provider Identifier
1174029748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8638
- Practice address
- 1900 Gordon Cooper Dr
Shawnee, OK 74801-8603 - Phone
- (405) 395-5806
- NPI assigned
- Apr 3, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8638 | OK | Primary |
Addresses
Primary practice location
1900 Gordon Cooper Dr
Shawnee, OK 74801-8603
Mailing address
2400 Whispering Pine Blvd
Shawnee, OK 74804-2409
Phone (580) 320-7115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8638 | Other | OK | OKLAHOMA STATE PHARMACY LICENSE NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8638 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522713600000",
"number": "1174029748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 WHISPERING PINE BLVD",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748042409",
"telephone_number": "580-320-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 GORDON COOPER DR",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748018603",
"telephone_number": "405-395-5806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENES",
"first_name": "JOHN",
"middle_name": "SCOTT",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-03",
"last_updated": "2018-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "8638",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA STATE PHARMACY LICENSE NUMBER",
"identifier": "8638",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.