Kevin M Renner, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

2017016516 Issued in MO

Practice address

225 Physicians Park Ste 102
Poplar Bluff, MO 63901-3918

Phone

(573) 785-4546

Fax

(573) 785-6959

NPI assigned

Mar 28, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.82 of 100Reported as group

Quality

72.99

Improvement activities

40

Cost

75.6

Procedures performed for Medicare patients

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.

• Preferred Podiatry Group PC

  • Podiatrist
  • Oak Harbor, WA
  • NPI 1720037138

  IL, MO, Single Specialty

  Medicare reassignment Care Compare group NPD
• Clint L Vanlandingham, DPM

  • Podiatrist
  • Poplar Bluff, MO
  • NPI 1508838566
  Medicare reassignment

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710305677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK DRIVE",
            "address_2": "SUITE 102",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "63901",
            "telephone_number": "573-785-4546",
            "fax_number": "573-785-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 102",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013918",
            "telephone_number": "573-785-4546",
            "fax_number": "573-785-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2017016516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2017016516",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Dean Reid, RN, BSN
• Paige Raelyn Reinbott, PHARMD
• Rely Quality Resources
• Renal Care Group of the Midwest, Inc.
• Renal Treatment Centers Illinois Inc
• Danny Richard Reynolds III
• Jessica Ralene Reynolds
• Pattie Rhine
• Jessica Rhodes
• Hannah Rice

• Foot & Ankle Surgery Podiatrist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Foot & Ankle Surgery Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.