Individual provider Active NPI

David D Reneau, D.C.

  • Chiropractor
  • Roseburg, OR
National Provider Identifier
1285787549
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 3193 Issued in OR
Practice address
535 NE Stephens St
Roseburg, OR 97470-3150
Phone
(541) 672-4807
Fax
(541) 672-7342
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27 3193 OR Primary

Addresses

Primary practice location

535 NE Stephens St
Roseburg, OR 97470-3150

Mailing address

535 NE Stephens St
Roseburg, OR 97470-3150
Phone (541) 672-4807

Other practice location 1

837 S Main St
Myrtle Creek, OR 97457-9334
Phone (541) 863-4920

Other practice location 2

2569 NW Edenbower Blvd
Roseburg, OR 97471-6220
Phone (541) 672-4807

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
27 3193ORMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1285787549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 NE STEPHENS ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703150",
            "telephone_number": "541-672-4807",
            "fax_number": "541-672-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 NE STEPHENS ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703150",
            "telephone_number": "541-672-4807",
            "fax_number": "541-672-7342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "837 S Main St",
            "address_purpose": "LOCATION",
            "city": "Myrtle Creek",
            "state": "OR",
            "postal_code": "974579334",
            "country_code": "US",
            "telephone_number": "541-863-4920",
            "fax_number": "541-860-5374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2569 NW Edenbower Blvd",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974716220",
            "country_code": "US",
            "telephone_number": "541-672-4807",
            "fax_number": "541-672-7342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENEAU",
        "first_name": "DAVID",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 3193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.