Jennae S Reken, DO
Individual provider Active NPI Pediatrics Physician · Columbia, MO
NPI 1194387845 · NPPES record last updated Jul 2, 2019
Key facts
- NPI
- 1194387845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 2019023980 (MO)
- Practice address
- 404 N Keene St
Columbia, MO 65201-6626 - Phone
- (573) 882-4438
- Fax
- (573) 884-9992
- NPI assigned
- Jul 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019023980 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates, Inc | Past | Accepting new patients | |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2019023980 | MO | Yes |
Addresses
Primary practice location
404 N Keene St
Columbia, MO 65201-6626
Mailing address
400 N Keene St
Columbia, MO 65201-6626
Phone (573) 882-4438
Other providers in Columbia, MO
- Bonnie Sue Reid
- Kelsey Ann Reid
- Rachel Reimers
- Taylor Reinsch
- Ronda Yvonne Oswalt Reitz
- Reliant Care Rehabilitation Services
- Reliant Care Rehabilitative Services L L C
- Robert Edward Remis
- Brooke Nicole Rempfer
- Renal Treatment Centers-Illinois Inc
All providers in Columbia, MO · Pediatrics Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.