Jack Alan Brewer, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD14911 Issued in OR

Practice address

2090 NE Wyatt CT
Suite 101
Bend, OR 97701-7687

Phone

(541) 382-6447

Fax

(541) 330-7413

NPI assigned

Apr 5, 2006

Last updated

Jan 9, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1518929439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 NE WYATT CT",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017687",
            "telephone_number": "541-382-6447",
            "fax_number": "541-330-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 NE WYATT CT",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017687",
            "telephone_number": "541-382-6447",
            "fax_number": "541-330-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "JACK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD14911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113050",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie L Brennecke
• Nicole Brenneman, LCSW
• Stefanie M Brennen
• Brent R. Wendel, DPM, LLC (Bend Foot and Ankle)
• Brent Reynolds Counseling, LLC (Hope Recovery)
• Jonathan Donald Brewer, D.O.
• Kerry Lynn Brewer, LMT
• Madison Ann Brewer, LMT
• Briana Fox Counseling, LLC
• Megan Brians, LMT

• Urology Physician in Bend, OR
• Providers in Bend, OR by specialty
• Urology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.