Brenda Mae Jedlicka, LMT

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

108329 Issued in AK

Practice address

2008 E Northern Lights Blvd
Anchorage, AK 99508-4101

Phone

(907) 274-2673

NPI assigned

Oct 2, 2018

Last updated

Feb 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brenda Mae Sease Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1558846899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 E NORTHERN LIGHTS BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084101",
            "telephone_number": "907-646-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 E NORTHERN LIGHTS BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084101",
            "telephone_number": "907-274-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDLICKA",
        "first_name": "BRENDA",
        "middle_name": "MAE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AK",
            "license": "108329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "SEASE",
            "middle_name": "MAE",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JC Faith Open Arms
• JC Faith Open Arms #1
• JC Faith Open Arms 1
• JC Faith Open Arms 3
• Devin A Jean-Marie
• Kimberly Jedlicka, M.D.
• Lawrence Jedlicka, MD
• Donna Jefferson, BS
• Tina Jefferson
• Kimberly Jeffery

• Rehabilitation Chiropractor in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Rehabilitation Chiropractor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; 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.