Individual provider Active NPI

Brenon Lett, LPN

  • Licensed Practical Nurse
  • Cleveland, OH
National Provider Identifier
1235331083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN116887 Issued in OH
Practice address
4361 Clarkwood Pkwy Apt 114
Cleveland, OH 44128-4872
Phone
(216) 701-6389
NPI assigned
Jun 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN116887 OH Primary

Addresses

Primary practice location

4361 Clarkwood Pkwy Apt 114
Cleveland, OH 44128-4872

Mailing address

4361 Clarkwood Pkwy Apt 114
Warrensville, OH 44128
Phone (216) 701-6389

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

State licenses

LicenseStateTypeSpecialty
PN116887OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Right Track Transportation Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235331083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 CLARKWOOD PKWY APT 114",
            "city": "WARRENSVILLE",
            "state": "OH",
            "postal_code": "44128",
            "telephone_number": "216-701-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 CLARKWOOD PKWY APT 114",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441284872",
            "telephone_number": "216-701-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETT",
        "first_name": "BRENON",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN116887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.