MR. NOLAN MARK RENNER PA-C
NPI 1174914758
Physician Assistant - Surgical in Fort Walton Beach, FL

Q: What is Nolan Renner's NPI number?

The NPI number for Nolan Renner is 1174914758. It was assigned to this individual provider in the NPPES registry on February 18, 2015.

Q: What is Nolan Renner's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Nolan Renner was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 18, 2015PECOS EnrolledAccepts Medicare Assignment

341 RACETRACK RD NW STE C, FORT WALTON BEACH, FL 32547(850) 226-8112(850) 362-6068 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 10, 2025, Sep 11, 2020, Jun 8, 2020 (3 updates tracked since 2020).

On this page

About Mr. Nolan Mark Renner Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. NOLAN MARK RENNER PA-C (NPI 1174914758) is an individual surgical provider in Fort Walton Beach, Florida, licensed in Florida (PA9108565) and active in the NPI registry since February 2015. He is enrolled in Medicare PECOS, is affiliated with North Okaloosa Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1174914758

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. NOLAN MARK RENNERCredential: PA-C

Location Address341 RACETRACK RD NW STE CFort Walton Beach, FL 32547-1788

Mailing AddressPo Box 370Fortson, GA 31808-0370 · Fax (706) 494-3008

Phone(850) 226-8112

Fax(850) 362-6068

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateFebruary 18, 2015

Last NPPES UpdateSeptember 10, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 10, 2025

✔ NPI 1174914758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9108565

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA 9108565 (FL)

341 RACETRACK RD NW STE C, Fort Walton Beach, FL 32547

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Nolan Mark Renner Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204147929

PECOS Enrollment IDI20150623000759

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

67 services67 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

46 services39 patients

Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement 27236

This procedure involves treating a fracture at the top of your thigh bone. A stabilizing device or prosthetic replacement is placed to aid in healing. This helps restore mobility and function while reducing pain. The treatment aims for a quick and safe recovery.

19 services19 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

17 services15 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

13 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Okaloosa Medical Center

Acute Care Hospitals · Crestview, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100122

Location151 Redstone Ave SECrestview, FL 32539 · Okaloosa County

Emergency services Birthing friendly

Hca Florida Fort Walton-Destin Hospital

Acute Care Hospitals · Fort Walton Beach, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100223

Location1000 Mar-Walt DrFort Walton Beach, FL 32547 · Okaloosa County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

13%75 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PAMELA JAMES WARNER D.O.

Orthopaedic Surgery (Orthopaedic Trauma)

341 RACETRACK RD NW STE C
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 226-8112

HUGHSTON CLINIC SOUTHEAST PC

Durable Medical Equipment & Medical Supplies

341 RACETRACK RD NW STE C
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 226-8112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nolan Renner's NPI number?

The NPI number for Nolan Renner is 1174914758. It was assigned to this individual provider in the NPPES registry on February 18, 2015.

Where is Nolan Renner located?

Nolan Renner practices at 341 Racetrack Rd NW Ste C, Fort Walton Beach, FL 32547. The listed phone number is (850) 226-8112.

What is Nolan Renner's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Nolan Renner enrolled in Medicare?

Yes. Nolan Renner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nolan Renner accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan and Ambetter of Alabama list Nolan Renner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nolan Renner affiliated with any hospitals?

According to CMS data, Nolan Renner is affiliated with North Okaloosa Medical Center and Hca Florida Fort Walton-Destin Hospital.

When was this NPI record last updated?

The NPPES record for Nolan Renner was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.