Brenna J. Petro, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN134782 Issued in AZ

Practice address

2199 N Merrit CRK Loop
Coeur D Alene, ID 83814-4949

Phone

(208) 665-7546

NPI assigned

Nov 24, 2009

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Idaho Dermatology IncGroup PAC ID 2365404431, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as apm

Quality

89.26

Promoting interoperability

69.9

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brennapetro@cqch.cernerdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Idaho Dermatology, Inc.

  • Dermatology Physician
  • Coeur d'Alene, ID
  • NPI 1215936638
  Medicare reassignment Care Compare group NPD
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  Nurse Practitioner

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bonner General Hospital Inc.

  dba Bonner General Health

  • Critical Access Hospital
  • Sandpoint, ID
  • NPI 1154563963
  Care Compare affiliation

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1174851497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2199 N MERRIT CRK LOOP",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144949",
            "telephone_number": "208-665-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2199 N MERRIT CRK LOOP",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144949",
            "telephone_number": "208-665-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "BRENNA",
        "middle_name": "J.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN134782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488480",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Peterson, LCSW
• Jill Peterson
• Katrina E Peterson, RD
• Makayla Bernadine Peterson
• Jared Petrick
• Thomas William Pettinger, MD
• Kale Pfeifer
• Shelley Rae Phillips, L.P.C.
• Physical Therapy & Sports Medicine Institute Inc
• Physiotherapy Associates

• Family Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.