Individual provider Active NPI

Chad Troy Rennie, MD

  • Emergency Medicine Physician
  • Fort Dodge, IA
National Provider Identifier
1174962021
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME151065 Issued in FL
Practice address
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Phone
(906) 235-9968
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301102698 MI
Emergency Medicine Physician 207P00000X ME151065 FL Primary

Addresses

Primary practice location

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Mailing address

3072 13TH Ave N
Fort Dodge, IA 50501-8006
Phone (906) 225-3864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006001411 FL Practitioner - Internal Medicine 1658506035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polk Emergency Group LLCGroup PAC ID 0547241598, 19 clinicians

Practice addresses (Care Compare)

2200 Osprey Blvd
Bartow, FL 33830-3308
Phone (863) 533-8111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Quality
88.09
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME151065FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Em Alliance LLC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Polk Emergency Group LLC Emergency Medicine CurrentSince Aug 27, 2021 Accepting new patients

Locations

2200 Osprey Blvd
Bartow, FL 33830
Phone (863) 519-1402

5506 14th St W
Bradenton, FL 34207
Phone (941) 745-7372

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

7 Easton Oval
#L4387
Columbus, OH 43219

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1174962021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3072 13TH AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505018006",
            "telephone_number": "906-225-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "906-235-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNIE",
        "first_name": "CHAD",
        "middle_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301102698",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME151065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.