Active NPI
TDR Inc
Doing business as Rennes Health Center DePere
- Skilled Nursing Facility
- De Pere, WI
National Provider Identifier
1932107422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2860
- Legal business name
- TDR INC
- Doing business as
- Rennes Health Center DePere
- Practice address
- 200 S 9TH St
De Pere, WI 54115-1393 - Phone
- (920) 336-5680
- NPI assigned
- Jul 8, 2005
- Last updated
- May 14, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Neil Johnson
- Title
- Treasurer
- Phone
- (715) 582-2200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2860 | WI | Primary |
Addresses
Primary practice location
200 S 9TH St
De Pere, WI 54115-1393
Mailing address
261 French St
Peshtigo, WI 54157-1217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20118400 | Medicaid | WI |
Other names 1
- Rennes Health Center DePere
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051020000899 | WI | Part A Provider - Skilled Nursing Facility | 0143246934 | Practice locations: De Pere, WI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1932107422. Details of each certification follow.
Skilled nursing facility certification: CCN 525573
- Legal name
- TDR INC
- Doing business as
- RENNES HEALTH AND REHAB CENTER DEPERE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1995
- Last certification
- Sep 18, 2024
- Beds
- 137
- Ownership / control type
- Corporation
- Multi-facility organization
- TDR, Inc.
- Organization structure
- Corporation
- Incorporated
- Apr 21, 1980 in WI
- Enrollment address
- 200 S 9TH St
De Pere, WI 54115-1393 - Nursing home name
- RENNES HEALTH AND REHAB CENTER-DE PERE
- Affiliated entity
- RENNES GROUP
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Rennes Health Center - Appleton
- Skilled Nursing Facility
- Appleton, WI
- NPI 1386642874
0143246934
-
dba Rennes Health Center - East
- Skilled Nursing Facility
- Peshtigo, WI
- NPI 1730187238
0143246934
-
dba Rennes Health & Rehab Center - Weston
- Skilled Nursing Facility
- Weston, WI
- NPI 1841438132
0143246934
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Rennes Health and Rehab Center-De Pere
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1995
- Medicare certification status
- Active
- Certified beds
- 137
- Chain
- Rennes Group
National Provider Directory
National Provider Directory- Tax ID family
- Rennes Health Center - Appleton
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Rennes Health & Rehab Center - Weston
- Skilled Nursing Facility
- Weston, WI
- NPI 1841438132
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Robert Lange | W-2 Managing Employee | Mar 30, 2022 | |
| Timothy Howard Rennes | 5% Or Greater Direct Ownership Interest | Jan 26, 1988 | 50% |
| Nicole Schingick | Corporate Officer | Dec 22, 2019 | |
| Debra Rennes | 5% Or Greater Direct Ownership Interest | Jan 26, 1988 | 50% |
Practitioners & affiliated clinicians
Affiliated clinicians 16
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Green Bay, WI
- NPI 1447348479
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210723200000",
"number": "1932107422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 FRENCH ST",
"city": "PESHTIGO",
"state": "WI",
"postal_code": "541571217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S 9TH ST",
"city": "DE PERE",
"state": "WI",
"postal_code": "541151393",
"telephone_number": "920-336-5680"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TDR INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-08",
"last_updated": "2008-05-14",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "NEIL",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "715-582-2200"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "2860",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20118400",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rennes Health Center DePere",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.