NPIMap

Individual provider Active NPI

Andrew S Brenner, MD

  • Emergency Medicine Physician
  • Bullhead City, AZ
National Provider Identifier
1467489435
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036052639 Issued in IL
Practice address
1570 Paseo Grande
#2024
Bullhead City, AZ 86442-8523
Phone
(217) 621-9007
NPI assigned
Jun 27, 2006
Last updated
Jun 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036052639 IL Primary

Addresses

Primary practice location

1570 Paseo Grande
#2024
Bullhead City, AZ 86442-8523

Mailing address

1570 Paseo Grande
#2024
Bullhead City, AZ 86442-8523
Phone (217) 621-9007

Other identifiers 1

IdentifierTypeStateIssuer
036052639MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients
Illiana Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Southwest Cardiovascular Associates Ahmed Alfafara and Prasad LTD Past Accepting new patients
Illiana Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Bestpractices of Illinois PC Emergency Medicine Past Accepting new patients
Hualapai Emergency Physician Partners PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine of Indiana Emergency Medicine Past Accepting new patients
Southwest Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/GBBICD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1467489435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 PASEO GRANDE",
            "address_2": "#2024",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428523",
            "telephone_number": "217-621-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 PASEO GRANDE",
            "address_2": "#2024",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428523",
            "telephone_number": "217-621-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "ANDREW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036052639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052639",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.