Active NPI
Mary Elizabeth Renner
- Pharmacist
- San Antonio, TX
National Provider Identifier
1649437070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-11387
- Practice address
- 17440 Henderson Pass
North Central Federal Clinic- Outpatient Pharmacy
San Antonio, TX 78232 - Phone
- (210) 483-2900
- NPI assigned
- May 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-11387 | KS | Primary |
| Pharmacist | 183500000X | 36489 | TX | |
| Pharmacist | 183500000X | 051-291240 | IL |
Addresses
Primary practice location
17440 Henderson Pass
North Central Federal Clinic- Outpatient Pharmacy
San Antonio, TX 78232
Mailing address
2243 Mountain Mist
San Antonio, TX 78258
Phone (830) 714-4750
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 |
|---|---|---|---|
| 36489 | TX | MD | General Practice Dentistry |
| 051-291240 | IL | MD | Pharmacist |
| 1-11387 | KS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1649437070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2243 MOUNTAIN MIST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78258",
"telephone_number": "830-714-4750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17440 HENDERSON PASS",
"address_2": "NORTH CENTRAL FEDERAL CLINIC- OUTPATIENT PHARMACY",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78232",
"telephone_number": "210-483-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNER",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-22",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-11387",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "36489",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-291240",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.