Physician Compare National (NPI:1477523512)

HEALTHCARE PROVIDER: KENT E RENAUD DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1477523512
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0042105397
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120430000432
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RENAUD
	Individual professional last name
Provider First Name	KENT
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DPM
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BLACK HILLS ORTHOPEDIC AND SPINE CENTER PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0648172932
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	60
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	825 CENTENNIAL DR
	Group Practice or individual's line 1 address
City	CHADRON
	Group Practice or individual's city
State	NE
	Group Practice or individual's state
Zip Code	693379400
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3084325586
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	430091
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BLACK HILLS SURGICAL HOSPITAL LLP
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	281341
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHADRON COMMUNITY HOSPITAL AND HEALTH SERVICES
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y