Brenda L Leverenz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003344 Issued in MI

Practice address

1217 Kearney St
Suite 1
Port Huron, MI 48060-3571

Phone

(810) 982-2095

Fax

(810) 982-8513

NPI assigned

Feb 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11879/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1437125408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 KEARNEY ST",
            "address_2": "SUITE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603571",
            "telephone_number": "810-982-2095",
            "fax_number": "810-982-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 KEARNEY ST",
            "address_2": "SUITE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603571",
            "telephone_number": "810-982-2095",
            "fax_number": "810-982-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERENZ",
        "first_name": "BRENDA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RAILROAD MEDICARE",
            "identifier": "P00221152",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David J Leslie, L.P.T.A.
• Michael William Lessie
• Leverenz Family Chiropractic PC
• Benjamin Leverenz
• Brandi Leverenz
• Jerry Douglas Lickfelt, CPSS
• Crystal Kay Lieblang, CNP
• Lighthouse Counseling & Testing Services, PLLC
• Sara E Liter-Kuester, DO
• Joe Zhaoping Liu, MD

• Physician Assistant in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.