Active NPI
Linda Renaud
- Case Manager/Care Coordinator
- Rego Park, NY
National Provider Identifier
1205198488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 14482
- Practice address
- 9777 Queens Blvd PH
Rego Park, NY 11374-3300 - Phone
- (347) 765-0697
- Fax
- (718) 228-4434
- NPI assigned
- Jun 13, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 14482 | NY | Primary |
Addresses
Primary practice location
9777 Queens Blvd PH
Rego Park, NY 11374-3300
Mailing address
1038 E 82ND St
Brooklyn, NY 11236-4224
Phone (347) 765-0697
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 |
|---|---|---|---|
| 14482 | NY | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339545600000",
"number": "1205198488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1038 E 82ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112364224",
"telephone_number": "347-765-0697",
"fax_number": "718-228-4434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9777 QUEENS BLVD PH",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743300",
"telephone_number": "347-765-0697",
"fax_number": "718-228-4434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENAUD",
"first_name": "LINDA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-13",
"last_updated": "2012-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NY",
"license": "14482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.