Individual provider Active NPI

Loren Clayton Schrenk, M.D.

  • Ophthalmology Physician
  • Saint Louis, MO
National Provider Identifier
1922002344
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R8F17 Issued in MO
Practice address
12818 Tesson Ferry Rd
Ste 201
Saint Louis, MO 63128-2945
Phone
(314) 843-4044
Fax
(314) 843-2941
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X R8F17 MO Primary
Ophthalmology Physician 207W00000X 03058639 IL

Addresses

Primary practice location

12818 Tesson Ferry Rd
Ste 201
Saint Louis, MO 63128-2945

Mailing address

12818 Tesson Ferry Rd
Ste 201
Saint Louis, MO 63128-2945
Phone (314) 843-4044

Other identifiers 2

IdentifierTypeStateIssuer
036058639MedicaidIL
202559308MedicaidMO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03058639ILMDOphthalmology Physician
R8F17MOMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1922002344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12818 TESSON FERRY RD",
            "address_2": "STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282945",
            "telephone_number": "314-843-4044",
            "fax_number": "314-843-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12818 TESSON FERRY RD",
            "address_2": "STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282945",
            "telephone_number": "314-843-4044",
            "fax_number": "314-843-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRENK",
        "first_name": "LOREN",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R8F17",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "03058639",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058639",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202559308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.