Active NPI
Donald Philip Renaldo, M.D.
- Ophthalmic Technician/Technologist
- Charlotte, NC
National Provider Identifier
1528021359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Technician/Technologist
- License
- 23322
- Practice address
- 1718 E 4TH St
Ste. 908
Charlotte, NC 28204-3260 - Phone
- (704) 376-5424
- Fax
- (704) 376-5354
- NPI assigned
- Apr 11, 2006
- 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 |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist | 156FX1100X | 23322 | NC | Primary |
Addresses
Primary practice location
1718 E 4TH St
Ste. 908
Charlotte, NC 28204-3260
Mailing address
1718 E 4TH St
Ste. 908
Charlotte, NC 28204-3260
Phone (704) 376-5424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8971240 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23322 | NC | MD | Ophthalmic Technician/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1528021359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1718 E 4TH ST",
"address_2": "STE. 908",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043260",
"telephone_number": "704-376-5424",
"fax_number": "704-376-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1718 E 4TH ST",
"address_2": "STE. 908",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043260",
"telephone_number": "704-376-5424",
"fax_number": "704-376-5354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENALDO",
"first_name": "DONALD",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1100X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic",
"state": "NC",
"license": "23322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8971240",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.