Laura Lynn Brennecke, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP015549 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4399

Phone

(215) 590-3630

NPI assigned

Oct 27, 2015

Last updated

Nov 14, 2019By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment NPD
• Childen's Health Care Associates Inc.

  dba CHCA Nurse Practitioners

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD
• Childrens Health Care Associates, Inc

  dba CHCA Gastroenterology & Nutrition

  • Pediatric Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1801981857
  NPD
• Panda Bear Pediatrics

  • Pediatrics Physician
  • Collegeville, PA
  • NPI 1497788327
  NPD (past)

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1174995310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SECOND AVE",
            "address_2": "SUITE 303",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263625",
            "telephone_number": "610-409-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNECKE",
        "first_name": "LAURA",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP015549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laura.brennecke@sluhn.org",
            "affiliation": "N",
            "endpointDescription": "new employment",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3401 Civic Center Blvd",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191044399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew James Brennan, DO
• Melissa Brennan
• Molly Erin Brennan, SLP
• Patrick J Brennan, MD
• Suzanne Marie Brennan, PHD RN
• Cheryl Brenneman
• Barry I. Brenner, D.D.S
• Barry Steven Brenner, MD
• Caitlyn Brenner, MD, MA
• Jacob Samuel Brenner, MD, PHD

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.