Individual provider Active NPI

Christina Michelle Brandenburg

  • Peer Specialist
  • Manchester, KY
National Provider Identifier
1154068427
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
205 Main St
Manchester, KY 40962-1259
Phone
(606) 596-0323
NPI assigned
May 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X KY Primary

Addresses

Primary practice location

205 Main St
Manchester, KY 40962-1259

Mailing address

205 Main St
Manchester, KY 40962-1259
Phone (606) 596-0323

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

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1154068427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621259",
            "telephone_number": "606-596-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621259",
            "telephone_number": "606-596-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "CHRISTINA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.