Individual provider Active NPI

John Patrick Brennan

  • Social Worker
  • Brockton, MA
National Provider Identifier
1508205063
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1115 W Chestnut St
Brockton, MA 02301-7501
Phone
(508) 580-5162
NPI assigned
Jun 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MA Primary

Addresses

Primary practice location

1115 W Chestnut St
Brockton, MA 02301-7501

Mailing address

252 High St
Pembroke, MA 02359-2707
Phone (781) 243-9017

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1508205063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 HIGH ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023592707",
            "telephone_number": "781-243-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "508-580-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.