Active NPI
Whitney R Renard
- Peer Specialist
- Bryan, OH
National Provider Identifier
1598271595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 200 Van Gundy Dr
Bryan, OH 43506-1153 - Phone
- (419) 636-0410
- Fax
- (419) 636-6510
- NPI assigned
- Dec 28, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
200 Van Gundy Dr
Bryan, OH 43506-1153
Mailing address
511 Perry St
Defiance, OH 43512-2123
Phone (419) 636-0410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164971 | Other | OH | LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514419200000",
"number": "1598271595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 PERRY ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122123",
"telephone_number": "419-636-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 VAN GUNDY DR",
"city": "BRYAN",
"state": "OH",
"postal_code": "435061153",
"telephone_number": "419-636-0410",
"fax_number": "419-636-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENARD",
"first_name": "WHITNEY",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-28",
"last_updated": "2017-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "164971",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryan, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.