Individual provider Active NPI

John Julian Renard, DPM

  • Foot Surgery Podiatrist
  • Appleton, WI
National Provider Identifier
1356378145
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
847025 Issued in WI
Practice address
2005 S. Lake Park Rd
Appleton, WI 54915
Phone
(920) 882-9990
Fax
(920) 882-9544
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 847025 WI Primary

Addresses

Primary practice location

2005 S. Lake Park Rd
Appleton, WI 54915

Mailing address

2005 S. Lake Park Rd
Appleton, WI 54915
Phone (920) 882-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080329000040 WI Practitioner - Podiatry 3577649649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2005 S Lake Park Rd
Appleton, WI 54915-4155
Phone (920) 882-9990

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
847025WIMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Renard Foot and Ankle LLC Foot Surgery CurrentSince Sep 12, 2014 Accepting new patients

Locations

2005 S Lake Park Rd
Appleton, WI 54915
Phone (920) 882-9990

702 Eisenhower Dr
Ste C
Kimberly, WI 54136
Phone (920) 380-0785

Organizations & group practices 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1356378145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 S. LAKE PARK RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54915",
            "telephone_number": "920-882-9990",
            "fax_number": "920-882-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 S. LAKE PARK RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54915",
            "telephone_number": "920-882-9990",
            "fax_number": "920-882-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENARD",
        "first_name": "JOHN",
        "middle_name": "JULIAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WI",
            "license": "847025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.