Brenden Bombardier
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Kansas City, KS
NPI 1144809153 · NPPES record last updated Apr 6, 2021
Key facts
- NPI
- 1144809153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3901 Rainbow Blvd # Ms 2027
Kansas City, KS 66160-8500 - Phone
- (913) 588-6050
- NPI assigned
- Apr 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210722000861 | KS | Order and Referring Only - Internal Medicine |
5092118455 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3901 Rainbow Blvd # Ms 2027
Kansas City, KS 66160-8500
Mailing address
3901 Rainbow Blvd # Ms 2027
Kansas City, KS 66160-8500
Phone (913) 588-6050
Other providers in Kansas City, KS
- David C Bodensteiner
- Brandon Paul Bodnariuk
- Brooke C Boehmer
- Kimberly R. Bogart
- Tonya Bolte
- Xiaowei Qiao Bombardier
- Lucas Bonachi Vergamini
- Lauren Bonci
- Justin Robert Bond
- Debra Ann Bonds
All providers in Kansas City, KS · Student in an Organized Health Care Education/Training Program in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.