Individual provider Active NPI

John H Von Brecht, M.D.

  • Nephrology Physician
  • Roseville, CA
National Provider Identifier
1508893173
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G54114 Issued in CA
Practice address
406 Sunrise Ave
# 260
Roseville, CA 95661-4106
Phone
(916) 773-1880
Fax
(916) 773-6883
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G54114 CA Primary

Addresses

Primary practice location

406 Sunrise Ave
# 260
Roseville, CA 95661-4106

Mailing address

406 Sunrise Ave
# 260
Roseville, CA 95661-4106
Phone (916) 773-1880

Other identifiers 1

IdentifierTypeStateIssuer
00G541141MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54114CAMDNephrology Physician

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": "1183852800000",
    "number": "1508893173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SUNRISE AVE",
            "address_2": "# 260",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614106",
            "telephone_number": "916-773-1880",
            "fax_number": "916-773-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SUNRISE AVE",
            "address_2": "# 260",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614106",
            "telephone_number": "916-773-1880",
            "fax_number": "916-773-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON BRECHT",
        "first_name": "JOHN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G54114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G541141",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.