Active NPI
H Dean Bresnahan, M. D.
- Family Medicine Physician
- Brattleboro, VT
National Provider Identifier
1396705273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- VT4607
- Practice address
- 53 Fairview St
Brattleboro, VT 05301-6630 - Phone
- (802) 257-1331
- Fax
- (802) 254-5567
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | VT4607 | VT | Primary |
Addresses
Primary practice location
53 Fairview St
Brattleboro, VT 05301-6630
Mailing address
30 Jenny LN
Brattleboro, VT 05301-8988
Phone (802) 257-1331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4510 | Medicaid | VT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| VT4607 | VT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509321600000",
"number": "1396705273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 JENNY LN",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053018988",
"telephone_number": "802-257-1331",
"fax_number": "802-254-5567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 FAIRVIEW ST",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053016630",
"telephone_number": "802-257-1331",
"fax_number": "802-254-5567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESNAHAN",
"first_name": "H",
"middle_name": "DEAN",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2017-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "VT4607",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4510",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.