Individual provider Active NPI

Kathy Berens-Brownmiller, PAC

  • Physician Assistant
  • Denison, IA
National Provider Identifier
1013987320
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00867 Issued in IA
Practice address
115 N 14TH St
Denison, IA 51442
Phone
(712) 263-5071
Fax
(712) 263-6106
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00867 IA Primary

Addresses

Primary practice location

115 N 14TH St
Denison, IA 51442

Mailing address

115 N 14TH St
Denison, IA 51442
Phone (712) 263-5071

Other identifiers 1

IdentifierTypeStateIssuer
0141002MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420000586 IA Practitioner - Physician Assistant 8921046988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crawford County Memorial HospitalGroup PAC ID 7810890555, 20 clinicians

Practice addresses (Care Compare)

100 Medical Pkwy
Denison, IA 51442-2299

100 Medical Pkwy
Denison, IA 51442-2607
Phone (712) 265-2500

Hospital & facility affiliations

  • Crawford County Memorial Hospital Hospital, Denison, IA, CCN 161369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00867IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford County Memorial Hospital Current Accepting new patients

Locations

100 Medical Pkwy
Denison, IA 51442
Phone (712) 265-2500

100 Medical Pkwy
Ste A
Denison, IA 51442
Phone (712) 263-5021

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/crawfco-0ba5dc4d
  • FHIR API: https://fhir-myrecord.cerner.com/r4/01ac1fad-f809-4c54-8fbc-c098bfca6c66/

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1013987320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N 14TH ST",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "51442",
            "telephone_number": "712-263-5071",
            "fax_number": "712-263-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N 14TH ST",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "51442",
            "telephone_number": "712-263-5071",
            "fax_number": "712-263-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENS-BROWNMILLER",
        "first_name": "KATHY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "00867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141002",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, IA

Sources for this page

Verify at the official NPI Registry.