Active NPI
Richard J Renner
- Pediatrics Physician
- Las Cruces, NM
National Provider Identifier
1558407684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00026458
- Practice address
- 390 Calle de Alegra
Las Cruces, NM 88005-3280 - Phone
- (575) 556-8200
- Fax
- (575) 556-8180
- NPI assigned
- Jan 29, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00026458 | WA | Primary |
Addresses
Primary practice location
390 Calle de Alegra
Las Cruces, NM 88005-3280
Mailing address
385 Calle de Alegra
BLDG. a
Las Cruces, NM 88005-3423
Phone (575) 526-1105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8114092 | Medicaid | WA |
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 |
|---|---|---|---|
| MD00026458 | WA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456444800000",
"number": "1558407684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 CALLE DE ALEGRA",
"address_2": "BLDG. A",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053423",
"telephone_number": "575-526-1105",
"fax_number": "575-524-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 CALLE DE ALEGRA",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053280",
"telephone_number": "575-556-8200",
"fax_number": "575-556-8180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNER",
"first_name": "RICHARD",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2016-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00026458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8114092",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
- G Ann Remick-Barlow, LISW
- Renal Care Group South New Mexico, LLC (Fresenius Medical Care Las Cruces)
- Renal Care Group South New Mexico, LLC (Fresenius Medical Care Las Cruces South)
- Renal Medicine of Las Cruces LLC
- Valerie Rendon
- Calandria Reno
- Jasmine Renteria, MSW INTERN
- Jose Renteria
- Maria Renteria
- Maria Renteria
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.