Breanna Brennecke

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5152-154 Issued in WI

Practice address

1821 S Stoughton Rd
Madison, WI 53716-2257

Phone

(608) 260-6000

Fax

(608) 260-6906

NPI assigned

Dec 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbrennecke410178@direct-ehr-ssmhc.com

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.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1548866056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 N STAR DR APT 315",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183011",
            "telephone_number": "715-219-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S STOUGHTON RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162257",
            "telephone_number": "608-260-6000",
            "fax_number": "608-260-6906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 Burke Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537186303",
            "country_code": "US",
            "telephone_number": "608-268-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Fakes Ct",
            "address_purpose": "LOCATION",
            "city": "Beaver Dam",
            "state": "WI",
            "postal_code": "539162699",
            "country_code": "US",
            "telephone_number": "920-356-9818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNECKE",
        "first_name": "BREANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "5152-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbrennecke410178@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bbrennecke410178@direct-ehr-ssmhc.com",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathryn Elizabeth Bremmon, PHARM.D.
• Jay Patrich Brendemuehl, RDH
• Benjamin Lind Brenkman
• Kenneth J Brennan, PHARM D
• Meghan B. Brennan, M.D.
• C. Brooks Brenneis, PH. D.
• Katherine Beatrice Brenneke, RN
• Robert Mendel Breslow, R.PH.
• Alison Bresnahan
• Amber Marie Brestel, MS CF-SLP

• Speech-Language Pathologist in Madison, WI
• Providers in Madison, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.