Individual provider Active NPI

Richard Reneau, D.C.

  • Chiropractor
  • Roseburg, OR
National Provider Identifier
1477892628
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5112 Issued in OR
Practice address
1632 NW Hughwood CT
Ste 1
Roseburg, OR 97471-8881
Phone
(541) 677-9199
Fax
(541) 672-4326
NPI assigned
Feb 7, 2013
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5112 OR Primary

Addresses

Primary practice location

1632 NW Hughwood CT
Ste 1
Roseburg, OR 97471-8881

Mailing address

325 Park Hill LN
Sutherlin, OR 97479-9022
Phone (541) 802-1040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150506001644 OR Practitioner - Chiropractic 0547582546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspen Injury Center LLCGroup PAC ID 4981938370, 4 clinicians

Practice addresses (Care Compare)

1240 E Main St
Cottage Grove, OR 97424-2217
Phone (541) 767-3788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5112ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Chiropractic PLLC Chiropractor Current Accepting new patients
Premier Chiropractic PC Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
Joshua B. Anderson, D.C.P.C. Chiropractor PastSince Sep 25, 2019 Accepting new patients

Locations

3000 Market St NE
Ste 266
Salem, OR 97301
Phone (503) 584-1620

3000 Market St NE
Ste 541
Salem, OR 97301
Phone (503) 584-1620

Organizations & group practices 5

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": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1477892628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PARK HILL LN",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974799022",
            "telephone_number": "541-802-1040",
            "fax_number": "541-802-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 NW HUGHWOOD CT",
            "address_2": "STE 1",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718881",
            "telephone_number": "541-677-9199",
            "fax_number": "541-672-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENEAU",
        "first_name": "RICHARD",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-07",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5112",
            "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 Sep 4, 2020; 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.