Active NPI
Gregory Marc Brenner, LSW
- Social Worker
- Johnstown, PA
National Provider Identifier
1497330898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 789 Goucher St
Johnstown, PA 15905-3028 - Phone
- (814) 536-0798
- NPI assigned
- Mar 17, 2021
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
789 Goucher St
Johnstown, PA 15905-3028
Mailing address
789 Goucher St
Johnstown, PA 15905-3028
Phone (814) 536-0798
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | wfcm@atlanticbbn.net | Direct |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1497330898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "789 GOUCHER ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159053028",
"telephone_number": "814-536-0798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "789 GOUCHER ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159053028",
"telephone_number": "814-536-0798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "GREGORY",
"middle_name": "MARC",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-17",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "wfcm@atlanticbbn.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "789 Goucher St",
"city": "Johnstown",
"state": "PA",
"country_code": "US",
"postal_code": "159053028",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Johnstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.