Individual provider Active NPI

Melanie Vega Renner, M.D.

  • Psychiatry Physician
  • Houma, LA
National Provider Identifier
1346300894
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
10867R Issued in LA
Practice address
5599 Highway 311
Houma, LA 70360-2866
Phone
(985) 857-3615
Fax
(985) 857-3706
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10867R LA Primary

Addresses

Primary practice location

5599 Highway 311
Houma, LA 70360-2866

Mailing address

5599 Highway 311
Houma, LA 70360-2866
Phone (985) 857-3615

Other identifiers 1

IdentifierTypeStateIssuer
1493287MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050224000022 LA Practitioner - Psychiatry 3072566637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10867RLAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central la Human Services Authority CurrentSince Dec 28, 2013 Accepting new patients
South Central la Human Services Authority Current Accepting new patients

Locations

158 Regal Row
Houma, LA 70360
Phone (985) 876-8889

5599 Highway 311
Houma, LA 70360
Phone (985) 857-3615

1809 W Airline Hwy
La Place, LA 70068
Phone (985) 652-8444

500 Roderick St
Ste B
Morgan City, LA 70380
Phone (985) 380-2460

157 Twin Oaks Dr
Raceland, LA 70394
Phone (985) 537-6823

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJJCA

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346300894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5599 HIGHWAY 311",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602866",
            "telephone_number": "985-857-3615",
            "fax_number": "985-857-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5599 HIGHWAY 311",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602866",
            "telephone_number": "985-857-3615",
            "fax_number": "985-857-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "MELANIE",
        "middle_name": "VEGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "10867R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1493287",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.