Terry Richard Brenneman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

27129 Issued in NC

Practice address

5816 Creedmoor Rd
Suite 104
Raleigh, NC 27612-2310

Phone

(919) 787-9555

Fax

(919) 510-5111

NPI assigned

Dec 19, 2007

Last updated

Dec 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11782/brand/1/csg/1/fhir/r4
• Direct secure messaging: terry.brenneman.1@11782.direct.athenahealth.com

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.

• Pediatric Partners PA

  dba Terry Brenneman, MD

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1730154857
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1588848006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 CREEDMOOR RD",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122310",
            "telephone_number": "919-787-9555",
            "fax_number": "919-510-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 CREEDMOOR RD",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122310",
            "telephone_number": "919-787-9555",
            "fax_number": "919-510-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNEMAN",
        "first_name": "TERRY",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "27129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "18164",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Rose Breneman, CCC-SLP
• Diana Brenish, FNP-C
• Brigid Mary Brennan, DPT
• Laci Ludlum Brennan
• Shannon R Brennan, LCMHC, LADC
• Amelia Brenner, LCSW
• Tara Faye Brenner, M.D.
• Rachel C Breslin, P.T.
• Michael Bressler
• Kristen R Brew, PEER SUPPORT

• Pediatrics Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.