Active NPI
Richard Charles Reno, M.D.
- Pediatrics Physician
- Destin, FL
National Provider Identifier
1295849438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME79721
- Practice address
- 990 Airport Road
Pediatric Department
Destin, FL 32541 - Phone
- (850) 269-6400
- Fax
- (850) 654-9581
- NPI assigned
- Aug 17, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME79721 | FL | Primary |
Addresses
Primary practice location
990 Airport Road
Pediatric Department
Destin, FL 32541
Mailing address
990 Airport Road
Pediatric Department
Destin, FL 32541
Phone (850) 269-6400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 251905900 | Medicaid | FL | |
| 58890 | Other | FL | FLORIDA BLUE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Uniformed Services Uhs Fe Hebert School of Med, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
990 Airport Rd
Destin, FL 32541-2820
Phone (850) 837-3848
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White-Wilson Medical Center PA | Current | Accepting new patients |
Locations
990 Airport Rd
Destin, FL 32541
Phone (850) 269-6400
1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100
Interoperability endpoints
- richard.reno.1@21123.direct.athenahealth.com
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.
-
- Clinic/Center
- Fort Walton Beach, FL
- NPI 1467437277
-
- Clinic/Center
- Fort Walton Beach, FL
- NPI 1225981707
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1295849438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 AIRPORT ROAD",
"address_2": "PEDIATRIC DEPARTMENT",
"city": "DESTIN",
"state": "FL",
"postal_code": "32541",
"telephone_number": "850-269-6400",
"fax_number": "850-654-9581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 AIRPORT ROAD",
"address_2": "PEDIATRIC DEPARTMENT",
"city": "DESTIN",
"state": "FL",
"postal_code": "32541",
"telephone_number": "850-269-6400",
"fax_number": "850-654-9581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENO",
"first_name": "RICHARD",
"middle_name": "CHARLES",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME79721",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "251905900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "58890",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.