Individual provider Active NPI

Daniel Grant Brewer, D.O.

  • Pediatrics Physician
  • Show Low, AZ
National Provider Identifier
1538570536
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
007286 Issued in AZ
Practice address
4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827
Phone
(928) 537-6700
Fax
(928) 532-2147
NPI assigned
May 13, 2014
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 007286 AZ Primary

Addresses

Primary practice location

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827

Mailing address

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827
Phone (928) 537-6700

Other practice location 1

3601 4th St
Lubbock, TX 79430-0002
Phone (806) 743-6630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170809001642 AZ Practitioner - Pediatric Medicine 2961700265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
007286AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates CurrentSince Aug 1, 2017 Accepting new patients
Summit Healthcare Association Current Accepting new patients
Summit Healthcare Medical Associates Pediatrics CurrentSince Aug 1, 2017 Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

1401 W Florida St
Holbrook, AZ 86025
Phone (928) 251-0386

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

3401 S White Mountain Rd
Ste E
Show Low, AZ 85901
Phone (928) 537-6792

4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 537-6700

5171 S Cub Lake Rd
Ste B230
Show Low, AZ 85901
Phone (928) 537-3500

5300 S Sutter Dr
Ste 1
Show Low, AZ 85901
Phone (928) 532-7546

Interoperability endpoints

  • Direct secure messaging: danielbrewer@shrmcshma.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Summit Healthcare PediatricsShow Low, AZ, CCN 033841 Rural health clinic W-2 Managing Employee Aug 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1538570536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-6630",
            "fax_number": "806-743-1599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "DANIEL",
        "middle_name": "GRANT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "007286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.