Bryson J Renouard

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

U4613 Issued in TX

Practice address

1441 E Dawn Dr
Salt Lake City, UT 84121-2702

Phone

(425) 879-3188

NPI assigned

Mar 23, 2020

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1811523715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 RUTHIE RUN",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137155",
            "telephone_number": "425-879-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 E DAWN DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212702",
            "telephone_number": "425-879-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENOUARD",
        "first_name": "BRYSON",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U4613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D'Covany Kalijah Mari Renick
• Dale G Renlund, MD
• David R Renner, MD
• Jamin Rennert
• Abigail Lee Reno
• Andrew Westley Renschler
• Juanita Denise Renteria
• Celina Lorraine Renzetti
• Daniel Kelly Renzo
• Reproductive Care Center

• Emergency Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.