David J Brenneman, M.D.
Individual provider Active NPI Anesthesiology Physician · Louisville, KY
NPI 1265794861 · NPPES record last updated May 19, 2019
Key facts
- NPI
- 1265794861
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 51808 (KY)
- Practice address
- 3812 Taylorsville Rd
Louisville, KY 40220-1304 - Phone
- (502) 451-9949
- Fax
- (502) 451-4553
- NPI assigned
- Jun 11, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- University of Connecticut School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Associates of Rock Hill PA
Practice addresses (Care Compare)
222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 985-3089
Hospital & facility affiliations
- Piedmont Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NC, KY, SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171205000274 | NC | Practitioner - Anesthesiology | 4183918535 | Reassigns benefits to 2 organizations |
| I20181219003478 | KY | Practitioner - Anesthesiology | 4183918535 | |
| I20200409003020 | SC | Practitioner - Anesthesiology | 4183918535 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51808 | KY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Anesthesiology Consultants, PLLC | Anesthesiology | Current |
Accepting new patients |
| Southeast Anesthesiology Consultants, PLLC | Anesthesiology | Current |
Accepting new patients |
| Anesthesia Associates of Rock Hill, P.a. | Anesthesiology | Current |
Accepting new patients |
| CHS Anesthesia Services Group Inc | Anesthesiology | Current |
Accepting new patients |
Locations
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
16455 Statesville Rd
Huntersville, NC 28078
Phone (704) 801-3719
222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950
Interoperability endpoints
- dbrenneman55062@enloedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2017-01339 | NC | |
| Anesthesiology Physician | 207L00000X | ME127465 | FL | |
| Anesthesiology Physician | 207L00000X | 51808 | KY | Yes |
Addresses
Primary practice location
3812 Taylorsville Rd
Louisville, KY 40220-1304
Mailing address
3100 Spring Forest Rd Ste 130
Raleigh, NC 27616-2880
Phone (919) 882-0774
Other practice location 1
Department Of Anesthesiology
Box 100254
Gainesville, FL 32610-0254
Phone (352) 273-8610
Other practice location 2
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017553500 | Medicaid | FL |
Other providers in Louisville, KY
- Courtney Brennan
- Meghan Elizabeth Brennan
- Michael Sean Brennan
- Paula Brennan
- Tiffany Anne Brennan
- Tracey Lynn Brennenstuhl
- Carol Brenner
- Lindsey Brennick
- Kayla Brenzel
- Sally Losson Brenzel
All providers in Louisville, KY · Anesthesiology Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.