Individual provider Active NPI

Kimberly Renk, PH.D.

  • Psychologist
  • Orlando, FL
National Provider Identifier
1770708422
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6771 Issued in FL
Practice address
7601 Conroy Windermere Rd
Orlando, FL 32835-2689
Phone
(407) 522-9919
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6771 FL Primary

Addresses

Primary practice location

7601 Conroy Windermere Rd
Orlando, FL 32835-2689

Mailing address

7601 Conroy Windermere Rd
Orlando, FL 32835-2689

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6771FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1770708422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 CONROY WINDERMERE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 CONROY WINDERMERE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352689",
            "telephone_number": "407-522-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENK",
        "first_name": "KIMBERLY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.