Charles Brentnall, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

00007246 Issued in AL

Legal business name

CHARLES BRENTNALL, M.D., P.A.

Practice address

7 Brown Ave
Sylacauga, AL 35150-2421

Phone

(256) 249-0358

Fax

(256) 249-8508

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Charles B Brentnall, MDNPI 1497751036

Title

President

Phone

(256) 249-0358

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles B Brentnall Jr., M.D., P.A.

  • Allergy Physician
  • Sylacauga, AL
  • NPI 1497751036
  Authorized official Same address or phone

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1023280716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2190",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351505190",
            "telephone_number": "256-249-0358",
            "fax_number": "256-249-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BROWN AVE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502421",
            "telephone_number": "256-249-0358",
            "fax_number": "256-249-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES BRENTNALL, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "BRENTNALL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-249-0358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "00007246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "510-02286",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000019927",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "C71170",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002286",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "510-19927",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Sylacauga, AL
• Providers in Sylacauga, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.