Active NPI
Keith Rennert
- Pharmacist
- Medford, OR
National Provider Identifier
1619448693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0016991
- Practice address
- 730 Biddle Rd
Medford, OR 97504-6116 - Phone
- (541) 494-3860
- NPI assigned
- Dec 17, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0016991 | OR | Primary |
Addresses
Primary practice location
730 Biddle Rd
Medford, OR 97504-6116
Mailing address
931 Chevy Way
Medford, OR 97504-4127
Other practice location 1
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone (541) 512-3190
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0016991 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1619448693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 CHEVY WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 BIDDLE RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046116",
"telephone_number": "541-494-3860"
}
],
"practiceLocations": [
{
"address_1": "3617 S Pacific Hwy",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975018957",
"country_code": "US",
"telephone_number": "541-512-3190",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RENNERT",
"first_name": "KEITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0016991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.