Mark Anthony Brenner, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

2229 Issued in MN

Practice address

2380 Troop Drive
Suite 201
Sartell, MN 56377-4637

Phone

(320) 252-5599

Fax

(320) 253-4585

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Cloud Chiropractic

  • Chiropractor
  • Saint Cloud, MN
  • NPI 1447476734

  Rehabilitation

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1013092162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 TROOP DRIVE",
            "address_2": "SUITE 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774637",
            "telephone_number": "320-252-5599",
            "fax_number": "320-253-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 TROOP DRIVE",
            "address_2": "SUITE 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774637",
            "telephone_number": "320-252-5599",
            "fax_number": "320-253-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "2229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "26817BR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808328200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Bosl, L.M.F.T
• Kaitlyn Mae Bottem
• Sara Ashley Botterill, M.D.
• Elizabeth Claire Boyd
• Riley Corey Boyer
• Bryan James Brindley, M.D.
• Taryn Elizabeth Broda
• Jasmine Brown
• Shawnee Brown
• Jurnee Bruggenthies

• All providers in Sartell, MN
• Rehabilitation Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.