Brentny Renfro, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.005105 Issued in IL

Practice address

2905 N Main St
Decatur, IL 62526-4274

Phone

(217) 877-6111

NPI assigned

Aug 5, 2014

Sex

Female

Sole proprietor

No

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brentny.renfro.p31@direct.fhn-fqhc.nextgenshare.com

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.

• Community Health Improvement Center

  • Federally Qualified Health Center (FQHC)
  • Decatur, IL
  • NPI 1467784090
  Medicare reassignment NPD
• Community Health Improvement Center

  • Federally Qualified Health Center (FQHC)
  • Decatur, IL
  • NPI 1831635770
  NPD

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1821407818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264274",
            "telephone_number": "217-877-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFRO",
        "first_name": "BRENTNY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thea Reese
• Jill Reich
• Sherry A Reid, MD
• Lauren Revelle Remley, CRNA
• Cheryl Lynn Remmert, MS CCC/SLP-L
• Sharon M Renfro
• Connie H Requarth, APN
• Restore Wellness Counseling LLC
• Jose Reyes, M.D.
• Callie Reynolds, PT, DPT

• Physician Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.