Active NPI
George Fraklin Rendleman Jr., MD
- Vascular Surgery Physician
- St Louis, MO
National Provider Identifier
1275753923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 27052
- Practice address
- 12723 Topping Acres
St Louis, MO 63131 - Phone
- (314) 966-6799
- Fax
- (314) 966-6799
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 27052 | MO | Primary |
Addresses
Primary practice location
12723 Topping Acres
St Louis, MO 63131
Mailing address
12723 Topping Acres
St Louis, MO 63131
Phone (314) 966-6799
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200C4301 | Medicaid | MO |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27052 | MO | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275753923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12723 TOPPING ACRES",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63131",
"telephone_number": "314-966-6799",
"fax_number": "314-966-6799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12723 TOPPING ACRES",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63131",
"telephone_number": "314-966-6799",
"fax_number": "314-966-6799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDLEMAN",
"first_name": "GEORGE",
"middle_name": "FRAKLIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MO",
"license": "27052",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200C4301",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.