Individual provider Active NPI

Brenda Mahnken, NP

  • Women's Health Nurse Practitioner
  • Marlborough, MA
National Provider Identifier
1265659429
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
233914 Issued in MA
Practice address
91 Main St
Marlborough, MA 01752-3845
Phone
(508) 854-3300
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 233914 MA Primary

Addresses

Primary practice location

91 Main St
Marlborough, MA 01752-3845

Mailing address

470 Pleasant St
Worcester, MA 01609-1823
Phone (508) 854-3300

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
233914MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of the North Country New York, Inc. Past Accepting new patients
Northern Adirondack Planned Parenthood Inc Past Accepting new patients
Planned Parenthood League of Massachusetts, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1265659429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 PLEASANT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091823",
            "telephone_number": "508-854-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MAIN ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523845",
            "telephone_number": "508-854-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNKEN",
        "first_name": "BRENDA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "233914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.