Active NPI
Brenna Fairweather
- Social Worker
- Chandler, AZ
National Provider Identifier
1205502549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 333 N Dobson Rd Ste 5
Chandler, AZ 85224-4412 - Phone
- (480) 280-8888
- NPI assigned
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
333 N Dobson Rd Ste 5
Chandler, AZ 85224-4412
Mailing address
333 N Dobson Rd Ste 5
Chandler, AZ 85224-4412
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://mod-well.com/ |
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": "1629158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1205502549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N DOBSON RD STE 5",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852244412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N DOBSON RD STE 5",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852244412",
"telephone_number": "480-280-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRWEATHER",
"first_name": "BRENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-17",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://mod-well.com/",
"affiliation": "N",
"address_1": "333 N Dobson Rd Ste 5",
"city": "Chandler",
"state": "AZ",
"country_code": "US",
"postal_code": "852244412",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.