Organization Active NPI

Jennifer Minnick Brennan, Aprn, BC LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Shrewsbury, NJ
National Provider Identifier
1366779571
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NC10476600 Issued in NJ
Legal business name
JENNIFER MINNICK BRENNAN, APRN, BC LLC
Practice address
621 Shrewsbury Ave
Shrewsbury, NJ 07702-4153
Phone
(732) 741-5544
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Jennifer Minnick Brennan, APRN, BC
Title
Director
Phone
(732) 546-6216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NC10476600 NJ Primary

Addresses

Primary practice location

621 Shrewsbury Ave
Shrewsbury, NJ 07702-4153

Mailing address

211 Beechwood Dr
Shrewsbury, NJ 07702-4467
Phone (732) 546-6216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091203000548 NJ Part B Supplier - Clinic/Group Practice 4688713621 Receives reassigned benefits from 1 practitioner
Practice locations: Red Bank, NJ

National Provider Directory

National Provider Directory

Locations

252 Broad St
Ste 2
Red Bank, NJ 07701
Phone (732) 741-5544

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1366779571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BEECHWOOD DR",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024467",
            "telephone_number": "732-546-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SHREWSBURY AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024153",
            "telephone_number": "732-741-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER MINNICK BRENNAN, APRN, BC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MINNICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-546-6216",
        "authorized_official_credential": "APRN, BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NC10476600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.