Daniel Clayton Brewer

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71009110A Issued in IN

Practice address

909 E State Blvd
Fort Wayne, IN 46805-3458

Phone

(260) 481-2700

Fax

(260) 481-2838

NPI assigned

Jun 27, 2019

Last updated

Jul 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dan Clayton Brewer Other name

Medicare fee-for-service enrollment

Enrolled in IN

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grant-Blackford Mental Health, Inc.Group PAC ID 9739177528, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marion General Hospital Hospital, Marion, IN, CCN 150011

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.

• Grant-Blackford Mental Health, Inc.

  dba Radiant Health Services

  • Community/Behavioral Health Agency
  • Marion, IN
  • NPI 1407848500
  Medicare reassignment Care Compare group NPD
• Park Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1306897004
  Medicare reassignment NPD
• Grant-Blackford Mental Health, Inc.

  dba Radiant Health Services

  • Community/Behavioral Health Agency
  • Marion, IN
  • NPI 1437983103
  NPD
• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD

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

• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Marion, IN
  • NPI 1770679201
  Care Compare affiliation
• Marion General Hospital

  dba Marion General Hospital Nutritional Support

  • Nutrition Support Registered Nurse
  • Marion, IN
  • NPI 1861578072

  Hospital

  Care Compare affiliation
• Marion General Hospital

  dba Marion General Hospital Ambulance Service

  • Land Ambulance
  • Marion, IN
  • NPI 1932295466

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1205497401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053458",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053458",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "DANIEL",
        "middle_name": "CLAYTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71009110A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28193276A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAN",
            "last_name": "BREWER",
            "middle_name": "CLAYTON",
            "credential": "PMHNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sean T Brennan
• Sierra Brennan
• Mandy Dawn Brenner, RRT
• Connor Steven Bresnahan, DDS
• Michael Bresnahan, RBT
• David Joseph-Dewayne Brewer
• Emma Brewer
• Logan Bricault
• Chelsea Bridge
• Bridges Dialysis LLC (Fort Wayne South Dialysis)

• Psychiatric/Mental Health Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• 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.