Kendra Renner

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4600 3Rd St
Moline, IL 61265-6106

Phone

(309) 779-2055

NPI assigned

Dec 7, 2018

Last updated

Dec 7, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Robert Young Center for Community Mental HealthGroup PAC ID 4587600150, shared by 3 NPIs, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Island, IL
  • NPI 1710276399
  Medicare reassignment NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Counselor
  • Rock Island, IL
  • NPI 1972272516

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  Medicare reassignment NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moline, IL
  • NPI 1912158494
  NPD
• Trinity Medical Center

  • Psychiatry Physician
  • Rock Island, IL
  • NPI 1033163829
  NPD
• The Robert Young Center for Community Mental Health

  dba Robert Young Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muscatine, IA
  • NPI 1063224426
  NPD

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1427529072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656106",
            "telephone_number": "309-779-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "KENDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12345",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regional Surgicenter, LTD
• Helena A Reid, DPM
• Tucker Reid
• Jane Reinhardt-Martin, R.D.
• Mark G Renier, R.PH.
• Shannon Reschke, LCSW
• Resolve Healthcare LLC
• Resolve Healthcare LLC
• Curtis L Rexroth, D.C.
• Breanna Catherine Reynolds, PT

• Mental Health Counselor in Moline, IL
• Providers in Moline, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.

Verify at the official NPI Registry.