Active NPI
Brenna Anne Eadie, PA-C
- Physician Assistant
- Deptford, NJ
National Provider Identifier
1497517023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1132 Cooper St
Deptford, NJ 08096-3014 - Phone
- (856) 848-8060
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1132 Cooper St
Deptford, NJ 08096-3014
Mailing address
505 Hillside Dr
West Chester, PA 19380-2357
Phone (610) 500-0400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1132 Cooper St
Suite 3
Deptford, NJ 08096-3014
Phone (856) 848-8060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Deptford, NJ
- NPI 1346725561
-
- Urgent Care Clinic/Center
- Deptford, NJ
- NPI 1285034108
-
- Primary Care Clinic/Center
- Deptford, NJ
- NPI 1538569454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1497517023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 HILLSIDE DR",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193802357",
"telephone_number": "610-500-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 COOPER ST",
"city": "DEPTFORD",
"state": "NJ",
"postal_code": "080963014",
"telephone_number": "856-848-8060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADIE",
"first_name": "BRENNA",
"middle_name": "ANNE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-29",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deptford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.