Angela R. Renner, D.C., P.a.
Organization Active NPI Chiropractor · Virginia, MN
NPI 1972540243 · NPPES record last updated Dec 22, 2008
Key facts
- NPI
- 1972540243
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4701 (MN)
- Legal business name
- ANGELA R. RENNER, D.C., P.A.
- Practice address
- 603 8TH St N
Virginia, MN 55792-2331 - Phone
- (218) 741-1888
- Fax
- (218) 741-4888
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Angela Rene Renner, D.C.
- Title
- President
- Phone
- (218) 741-1888
Practitioners 1
-
Angela Rene Renner, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051028000271 | MN | Part B Supplier - Clinic/Group Practice | 7810914959 |
Receives reassigned benefits from 1 practitioner Practice locations: Virginia, MN |
National Provider Directory
Locations
603 8th St N
Virginia, MN 55792
Phone (218) 741-1888
124 Chestnut St
Virginia, MN 55792
Phone (218) 741-1888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 4701 | MN | Yes |
Addresses
Primary practice location
603 8TH St N
Virginia, MN 55792-2331
Mailing address
603 8TH St N
PO Box 1014
Virginia, MN 55792-2331
Phone (218) 741-1888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221092400 | Other | MN | MHCP PROVIDER NUMBER |
| 276P6RE | Other | MN | PARTICIPATING BCBS PROV # |
Other names
- Northland Chiropractic
Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.