MR. NOLAN MARK RENNER (PA-C) – Surgical Physician Assistant, NPI 1174914758
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for MR. NOLAN MARK RENNER (PA-C)
PO BOX 370
FORTSON, GA 318080370
Phone:
Fax: (706) 494-3008
Type: Mailing
341 RACETRACK RD NW STE C
FORT WALTON BEACH, FL 325471788
Phone: (850) 226-8112
Fax: (850) 362-6068
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $127.
Total Amount is formed as General ($127) + Research ($0) + Ownership ($0) = $127.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: KCI USA, Inc. ($59).
Total Amount
$127
General + Research + Ownership
Payments
4
Total payment records
General Amount
$127
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| KCI USA, Inc. | $59 |
| Bioventus LLC | $46 |
| DePuy Synthes Sales Inc. | $22 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-06-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150623000759 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 52 | 52 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 47 | 44 | $0 |
| 73502 | X-ray of hip, 2-3 views | 27 | 21 | $0 |
| 99221 | Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | 24 | 24 | $0 |
| 73610 | X-ray of ankle, minimum of 3 views | 21 | 17 | $0 |
Insurance plans in this area (ZIP 31808)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | OH | |
| Physician Assistant | FL | |
| Physician Assistant | GA | |
| Orthopedic Surgery | GA | |
| Physician Assistant | FL | |
| Physician Assistant | GA | |
| Orthopedic Surgery | GA | |
| Physician Assistant | GA | |
| Orthopedic Surgery | GA | |
| Osteopathic Manipulative Medicine | GA |
Reviews
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