Active NPI
Kristi Renneker, MSPT
- Pediatric Physical Therapist
- Birmingham, AL
National Provider Identifier
1831294420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2206
- Practice address
- 234 Goodwin Crest Dr
Birmingham, AL 35209-3701 - Phone
- (205) 290-4550
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2206 | AL | Primary |
Addresses
Primary practice location
234 Goodwin Crest Dr
Birmingham, AL 35209-3701
Mailing address
234 Goodwin Crest Dr
Birmingham, AL 35209-3701
Phone (205) 290-4550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51536496 | Other | AL | BCBS |
| 890018760 | Medicaid | AL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2206 | AL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473120000000",
"number": "1831294420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 GOODWIN CREST DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352093701",
"telephone_number": "205-290-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 GOODWIN CREST DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352093701",
"telephone_number": "205-290-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNEKER",
"first_name": "KRISTI",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2016-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AL",
"license": "2206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51536496",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890018760",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.