Individual provider Active NPI

Donald Eugene Reneau, DC

  • Sports Physician Chiropractor
  • Roseburg, OR
National Provider Identifier
1447384433
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
273086 Issued in OR
Practice address
780 NW Garden Valley Blvd
Suite 300
Roseburg, OR 97470-1955
Phone
(541) 677-9199
Fax
(541) 672-4326
NPI assigned
Mar 14, 2007
Last updated
Jan 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 273086 OR Primary

Addresses

Primary practice location

780 NW Garden Valley Blvd
Suite 300
Roseburg, OR 97470-1955

Mailing address

780 NW Garden Valley Blvd
Suite 300
Roseburg, OR 97470-2195
Phone (541) 677-9199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000826 OR Practitioner - Chiropractic 0648352120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1632 NW Hughwood CT
Roseburg, OR 97471-8881
Phone (541) 677-9199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
273086ORMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roseburg Chiropractic PC CurrentSince Jun 4, 2008 Accepting new patients
Reneau Chiropractic P.C. Past Accepting new patients

Locations

1632 NW Hughwood Ct
Ste 1
Roseburg, OR 97471
Phone (541) 677-9199

780 NW Garden Valley Blvd
Ste 300
Roseburg, OR 97471
Phone (541) 677-9199

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1447384433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 NW GARDEN VALLEY BLVD",
            "address_2": "SUITE 300",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702195",
            "telephone_number": "541-677-9199",
            "fax_number": "541-672-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NW GARDEN VALLEY BLVD",
            "address_2": "SUITE 300",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701955",
            "telephone_number": "541-677-9199",
            "fax_number": "541-672-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENEAU",
        "first_name": "DONALD",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "273086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.