Stephen Renick Jr., D.C.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

CH9701 Issued in FL

Practice address

2658 Maguire Rd
Ocoee, FL 34761-4752

Phone

(407) 877-2400

Fax

(407) 877-0958

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Primo Spine LLC

  • Chiropractor
  • Windermere, FL
  • NPI 1669359782
  NPD

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1619976743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614752",
            "telephone_number": "407-877-2400",
            "fax_number": "407-877-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2658 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614752",
            "telephone_number": "407-877-2400",
            "fax_number": "407-877-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENICK",
        "first_name": "STEPHEN",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X2538",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH9701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Reedy, PA-C
• Sara Lyn Reese, MSPT
• Rehabclinics Pta, Inc.
• Julianna Rehberg
• Nikki Anne Reis, ATC, LAT
• Resilience Counseling and Psychotherapy, LLC
• Resilient Mind Mental Health & Behavioral Care, LLC
• Revive Chiropractic Care, LLC
• Johanna Divina Reyes, PT, DPT
• Charlene Reynolds, CRNA

• Nutrition Chiropractor in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Nutrition Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.