Andrew Renner, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01078400A Issued in IN

Practice address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

Phone

(855) 875-6333

NPI assigned

Apr 9, 2013

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1740623719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S SAINT LOUIS BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172924",
            "telephone_number": "574-233-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "855-875-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1356 Lusitana St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132409",
            "country_code": "US",
            "telephone_number": "808-586-2920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENNER",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "HI",
            "license": "MDR-6524",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01078400A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Reid
• James E Reidy, M.D.
• Reliable Medical Supply LLC
• Haylee Marie Rella
• Brody Eelco Remble
• Holly Maye Renner
• Ariel Renae Rentfrow
• Rekha Rethiyamma, DMD
• Stephanie Reynolds, MSW
• Thomas K Rhee, MD

• Anesthesiology Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.