Individual provider Active NPI

Brenna Kelley Vanfrank, MD, MSPH

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1265758627
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD2013-0108 Issued in NM
Practice address
4770 Buford Hwy NE
Mail Stop F-77, Division of Nutrition
Atlanta, GA 30341
Phone
(770) 488-5609
Fax
(770) 488-5369
NPI assigned
Apr 10, 2010
Last updated
Aug 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD2013-0108 NM Primary

Addresses

Primary practice location

4770 Buford Hwy NE
Mail Stop F-77, Division of Nutrition
Atlanta, GA 30341

Mailing address

4770 Buford Hwy NE
Mail Stop F-77, Division of Nutrition
Atlanta, GA 30341
Phone (770) 488-5609

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2013-0108NMMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1270857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1265758627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BUFORD HWY NE",
            "address_2": "MAIL STOP F-77, DIVISION OF NUTRITION",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "770-488-5609",
            "fax_number": "770-488-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 BUFORD HWY NE",
            "address_2": "MAIL STOP F-77, DIVISION OF NUTRITION",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "770-488-5609",
            "fax_number": "770-488-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANFRANK",
        "first_name": "BRENNA",
        "middle_name": "KELLEY",
        "credential": "MD, MSPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-10",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2013-0108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.