Stephen Louis Brenneke, M.D.

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

MD11314 Issued in OR

Practice address

10121 SE Sunnyside Rd
Suite 130
Clackamas, OR 97015-5745

Phone

(503) 766-3545

Fax

(503) 342-3766

NPI assigned

Oct 19, 2005

Last updated

Mar 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Stephen L Brenneke, M.D., P.C.

  • Specialist
  • Portland, OR
  • NPI 1881868099
  NPD (past) Authorized official

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1194714303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10121 SE SUNNYSIDE RD",
            "address_2": "SUITE 130",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155745",
            "telephone_number": "503-766-3545",
            "fax_number": "503-342-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 SE SUNNYSIDE RD",
            "address_2": "SUITE 130",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155745",
            "telephone_number": "503-766-3545",
            "fax_number": "503-342-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNEKE",
        "first_name": "STEPHEN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OR",
            "license": "MD11314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "112187",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyn Brady, RN
• Cynthia Jean Braunstein
• Braver Than You Believe Counseling, LLC
• Carrie Lynn Breeden, O.D.
• Ruth Ann Breitenbach, RN
• Rachel Jaye Brenner, M.D.
• Kathryn Margaret Breslin, MD
• Bret T Kean MD PC
• Marie Sherleen Nera Brigham, M.D.
• Brightsteps Care LLC

• Adult Reconstructive Orthopaedic Surgery Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.