Active NPI
Jeffrey Gerard Brenner, PA-C
- Medical Physician Assistant
- Springport, MI
National Provider Identifier
1295863314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601001774
- Practice address
- 400 E Main St
Ste 200
Springport, MI 49284-9774 - Phone
- (517) 857-4500
- Fax
- (517) 857-4510
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601001774 | MI | Primary |
Addresses
Primary practice location
400 E Main St
Ste 200
Springport, MI 49284-9774
Mailing address
400 E Main St
Ste 200
Springport, MI 49284-9774
Phone (517) 857-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601001774 | Other | MI | STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601001774 | MI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lansing Urgent Care, PLC | Past | Accepting new patients | |
| Life Care Sleep and Health Center LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Urgent Care Clinic/Center
- Lansing, MI
- NPI 1780987990
-
- Sleep Disorder Diagnostic Clinic/Center
- Lansing, MI
- NPI 1477584688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1295863314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E MAIN ST",
"address_2": "STE 200",
"city": "SPRINGPORT",
"state": "MI",
"postal_code": "492849774",
"telephone_number": "517-857-4500",
"fax_number": "517-857-4510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E MAIN ST",
"address_2": "STE 200",
"city": "SPRINGPORT",
"state": "MI",
"postal_code": "492849774",
"telephone_number": "517-857-4500",
"fax_number": "517-857-4510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "JEFFREY",
"middle_name": "GERARD",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601001774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "5601001774",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springport, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.