Individual provider Active NPI

Douglas C Brengle, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1376581397
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35059785B Issued in OH
Practice address
3805 Edwards Rd
Ste. 300
Cincinnati, OH 45209-1900
Phone
(513) 585-9700
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35059785B OH Primary

Addresses

Primary practice location

3805 Edwards Rd
Ste. 300
Cincinnati, OH 45209-1900

Mailing address

3805 Edwards Rd
Suite 300
Cincinnati, OH 45209-1900
Phone (513) 585-9700

Other identifiers 1

IdentifierTypeStateIssuer
0796876MedicaidOH

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
35059785BOHMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1376581397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 EDWARDS RD",
            "address_2": "SUITE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091900",
            "telephone_number": "513-585-9700",
            "fax_number": "513-585-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 EDWARDS RD",
            "address_2": "STE. 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091900",
            "telephone_number": "513-585-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENGLE",
        "first_name": "DOUGLAS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35059785B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0796876",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.