Individual provider Active NPI

Brenna Holmberg, PA

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1205681707
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.009400RX Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-6200
Fax
(614) 722-3903
NPI assigned
Apr 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.009400RX OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-6200

Other practice location 1

536 S Trimble Rd
Mansfield, OH 44906-3418
Phone (614) 722-6200

Other practice location 2

5665 Venture Dr
Dublin, OH 43017-2159
Phone (614) 722-6200

Other practice location 3

555 S 18th St
Columbus, OH 43205-2654
Phone (614) 722-6200

Other practice location 4

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-6200

Other practice location 5

405 Butterfly Gardens Dr
Columbus, OH 43215-4985
Phone (614) 722-6200

Other identifiers 1

IdentifierTypeStateIssuer
0138825MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20250915001721 OH Practitioner - Physician Assistant 5092218081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Childrens Dr
Columbus, OH 43205-2639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children's Hospital CurrentSince Sep 1, 2025 Accepting new patients
Nationwide Children's Hospital Past Accepting new patients

Locations

405 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 722-4200

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

5665 Venture Dr
Dublin, OH 43017
Phone (614) 355-8480

536 S Trimble Rd
Mansfield, OH 44906
Phone (419) 528-3150

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1205681707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5665 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154985",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMBERG",
        "first_name": "BRENNA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009400RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138825",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.