Active NPI
Robert Renier, PTA
- Physical Therapy Assistant
- Elgin, IL
National Provider Identifier
1477060697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160004222
- Practice address
- 790 Fletcher Dr
Elgin, IL 60123-4755 - Phone
- (847) 697-7800
- NPI assigned
- Jan 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160004222 | IL | Primary |
Addresses
Primary practice location
790 Fletcher Dr
Elgin, IL 60123-4755
Mailing address
790 Fletcher Dr
Elgin, IL 60123-4755
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160.004222 | Other | IL | PEDIATRIC PHYSICAL THERAPY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160004222 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1477060697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 FLETCHER DR",
"city": "ELGIN",
"state": "IL",
"postal_code": "601234755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 FLETCHER DR",
"city": "ELGIN",
"state": "IL",
"postal_code": "601234755",
"telephone_number": "847-697-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENIER",
"first_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-09",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160004222",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEDIATRIC PHYSICAL THERAPY",
"identifier": "160.004222",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.