Individual provider Active NPI

Robert C Rendina, D.C.

  • Chiropractor
  • Ruston, LA
National Provider Identifier
1912051962
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
672 Issued in LA
Practice address
103 W Georgia Ave
Ruston, LA 71270-3846
Phone
(318) 251-2243
Fax
(318) 251-2266
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 672 LA Primary

Addresses

Primary practice location

103 W Georgia Ave
Ruston, LA 71270-3846

Mailing address

103 W Georgia Ave
Ruston, LA 71270-3846
Phone (318) 251-2243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101221000463 LA Practitioner - Chiropractic 2264620061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 W Georgia Ave
Ruston, LA 71270-3846
Phone (318) 251-2243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
672LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert C. Rendina, D.C., Apc Chiropractor CurrentSince Sep 13, 2010 Accepting new patients

Locations

103 W Georgia Ave
#C
Ruston, LA 71270

103 W Georgia Ave
Ruston, LA 71270
Phone (318) 251-2243

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912051962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W GEORGIA AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703846",
            "telephone_number": "318-251-2243",
            "fax_number": "318-251-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W GEORGIA AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703846",
            "telephone_number": "318-251-2243",
            "fax_number": "318-251-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDINA",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.