Individual provider Active NPI

Ronald L Brittner, DPM

  • Podiatrist
  • Pennsville, NJ
National Provider Identifier
1124029533
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00094200 Issued in NJ
Practice address
390 N Broadway
Suite 1100
Pennsville, NJ 08070-1258
Phone
(856) 678-6665
Fax
(856) 678-7877
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00094200 NJ Primary

Addresses

Primary practice location

390 N Broadway
Suite 1100
Pennsville, NJ 08070-1258

Mailing address

390 N Broadway
Suite 1100
Pennsville, NJ 08070-1258
Phone (856) 678-6665

Other identifiers 1

IdentifierTypeStateIssuer
2407906MedicaidNJ

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1124029533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N BROADWAY",
            "address_2": "SUITE 1100",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701258",
            "telephone_number": "856-678-6665",
            "fax_number": "856-678-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N BROADWAY",
            "address_2": "SUITE 1100",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701258",
            "telephone_number": "856-678-6665",
            "fax_number": "856-678-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTNER",
        "first_name": "RONALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00094200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2407906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.