Bradley Russell Drennen, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

05008398L Issued in PA

Practice address

1322 Eisenhower Blvd
Johnstown, PA 15904-3307

Phone

(814) 266-8840

Fax

(814) 266-2176

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdren@pcs.medentdirect.com

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.

• Pediatric Care Specialists

  • Multi-Specialty Clinic/Center
  • Johnstown, PA
  • NPI 1346236833
  Medicare reassignment NPD
• Childrens Community Pediatrics

  • Pediatrics Physician
  • Monroeville, PA
  • NPI 1740244110
  NPD (past)
• DLP Conemaugh Memorial Medical Center LLC

  dba Conemaugh Memorial Medical Center

  • General Acute Care Hospital
  • Johnstown, PA
  • NPI 1801897038
  NPD (past)
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1215993340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043307",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043307",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNEN",
        "first_name": "BRADLEY",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "05008398L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014861460001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.