Individual provider Active NPI

Ronald Thomas Wren Jr., PA C

  • Physician Assistant
  • Redfield, SD
National Provider Identifier
1497779805
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0621 Issued in SD
Practice address
1010 W 1St St
Redfield, SD 57469-1506
Phone
(605) 472-0510
Fax
(605) 472-0331
NPI assigned
Jul 27, 2006
Last updated
Jun 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0621 SD Primary

Addresses

Primary practice location

1010 W 1St St
Redfield, SD 57469-1506

Mailing address

PO Box 590
Redfield, SD 57469-0590
Phone (605) 472-0510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060802000135 SD Practitioner - Physician Assistant 7911970454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of RedfieldGroup PAC ID 5698757631, 12 clinicians

Practice addresses (Care Compare)

1010 W 1St St
Redfield, SD 57469-1502
Phone (605) 472-0510

111 W 10TH Ave
Redfield, SD 57469-1519
Phone (605) 475-7402

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.27 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0621SDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
City of Redfield CurrentSince Jun 12, 2006 Accepting new patients
City of Redfield CurrentSince Jan 1, 2026 Accepting new patients
City of Redfield PastSince Apr 25, 2021 Accepting new patients
City of Redfield Past Accepting new patients

Locations

1010 W 1st St
Redfield, SD 57469
Phone (605) 472-0510

111 W 10th Ave
Redfield, SD 57469
Phone (605) 472-1110

Interoperability endpoints

  • Direct secure messaging: ronald.wren@avera.sdhealthlink.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1497779805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 590",
            "city": "REDFIELD",
            "state": "SD",
            "postal_code": "574690590",
            "telephone_number": "605-472-0510",
            "fax_number": "605-472-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W 1ST ST",
            "city": "REDFIELD",
            "state": "SD",
            "postal_code": "574691506",
            "telephone_number": "605-472-0510",
            "fax_number": "605-472-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "RONALD",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redfield, SD

Sources for this page

Verify at the official NPI Registry.