Active NPI
Shea M Breneman, D.C.
- Chiropractor
- Marysville, WA
National Provider Identifier
1083044283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH60402217
- Practice address
- 1507 172ND St NE
Marysville, WA 98271-5484 - Phone
- (563) 340-1220
- NPI assigned
- Nov 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH60402217 | WA | Primary |
Addresses
Primary practice location
1507 172ND St NE
Marysville, WA 98271-5484
Mailing address
1507 172ND St NE
Marysville, WA 98271-5484
Phone (563) 340-1220
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 |
|---|---|---|---|
| CH60402217 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385337600000",
"number": "1083044283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1507 172ND ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982715484",
"telephone_number": "563-340-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 172ND ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982715484",
"telephone_number": "563-340-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENEMAN",
"first_name": "SHEA",
"middle_name": "M",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-25",
"last_updated": "2013-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH60402217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.