Individual provider Active NPI

Tiffany Renaud, D.C.

  • Chiropractor
  • South Burlington, VT
National Provider Identifier
1326122623
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006-0000905 Issued in VT
Practice address
3000 Williston Rd
Suite 3
South Burlington, VT 05403-6082
Phone
(802) 658-6092
Fax
(802) 863-9565
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006-0000905 VT Primary

Addresses

Primary practice location

3000 Williston Rd
Suite 3
South Burlington, VT 05403-6082

Mailing address

3000 Williston Rd
Suite 3
South Burlington, VT 05403-6082
Phone (802) 658-6092

Other identifiers 1

IdentifierTypeStateIssuer
00018436OtherVTBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000821 VT Practitioner - Chiropractic 5092783001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tiffany Renaud, Inc.Group PAC ID 8022279074, 7 clinicians

Practice addresses (Care Compare)

1 Market PL
Unit 27
Essex JCT, VT 05452-2942
Phone (802) 658-6092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006-0000905VTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tiffany Renaud, Inc. CurrentSince Feb 13, 2012 Accepting new patients
Tiffany Renaud, Inc. Chiropractor CurrentSince Feb 14, 2012 Accepting new patients

Locations

1 Towne Market Pl
Unit 27
Essex Junction, VT 05452
Phone (802) 658-6092

3000 Williston Rd
Ste 3
South Burlington, VT 05403
Phone (802) 658-6092

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1326122623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WILLISTON RD",
            "address_2": "SUITE 3",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036082",
            "telephone_number": "802-658-6092",
            "fax_number": "802-863-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 WILLISTON RD",
            "address_2": "SUITE 3",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036082",
            "telephone_number": "802-658-6092",
            "fax_number": "802-863-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006-0000905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00018436",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.