Active NPI
Jacob Michael Brening, ATC
- Athletic Trainer
- Cleveland, TN
National Provider Identifier
1003905985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0000000990
- Practice address
- 1120 North Ocoee
Lee University Athletics
Cleveland, TN 37311 - Phone
- (423) 614-8527
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0000000990 | TN | Primary |
Addresses
Primary practice location
1120 North Ocoee
Lee University Athletics
Cleveland, TN 37311
Mailing address
2191 Old Harrison Pike NW
Apt 2
Cleveland, TN 37311-1098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000000990 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003905985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2191 OLD HARRISON PIKE NW",
"address_2": "APT 2",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373111098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 NORTH OCOEE",
"address_2": "LEE UNIVERSITY ATHLETICS",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "37311",
"telephone_number": "423-614-8527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENING",
"first_name": "JACOB",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "0000000990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.