Kathleen Miller Brandenburg

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5012514 Issued in NC

Practice address

601 E Portersville Rd
Portersville, PA 16051-2119

Phone

(724) 601-3474

NPI assigned

Jul 20, 2006

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary Kathleen Miller Former name

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbrandenburg1238504@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  NC, SC

  Medicare reassignment NPD
• Novant Health Employer Solutions, LLC

  dba NHES Ins Bill

  • Occupational Medicine Physician
  • Charlotte, NC
  • NPI 1407668700
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  NPD
• Infinity Health Care, LLC

  • Nursing Care Agency
  • Westlake, OH
  • NPI 1902851587
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1437179702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6388 MAZELLE TRL SW",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284695777",
            "telephone_number": "910-520-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E PORTERSVILLE RD",
            "city": "PORTERSVILLE",
            "state": "PA",
            "postal_code": "160512119",
            "telephone_number": "724-601-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "KATHLEEN",
        "middle_name": "MILLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012514",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP007684",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SP007684",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY KATHLEEN",
            "last_name": "MILLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• 4 U Mobility Solutions LLC
• Asv Mobility Co
• Jason P Benton, CRNP
• Ann Michelle Druschel, RN
• Ryan Garlick
• Albert Mark Geniviva, R.PH.
• Rhiannon Mae Hill, CRNP
• Joshua Everett Huber, DPT

• Nurse Practitioner in Portersville, PA
• Providers in Portersville, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.