Individual provider Active NPI

Brenda J Pittman, NP

  • Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1609884287
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4221P Issued in KY
Practice address
3300 Tates Creek Rd
Lexington, KY 40502-3408
Phone
(859) 266-2126
Fax
(859) 266-5353
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4221P KY Primary

Addresses

Primary practice location

3300 Tates Creek Rd
Lexington, KY 40502-3408

Mailing address

12201 Bluegrass Pkwy
Louisville, KY 40299-2361
Phone (502) 568-7364

Other identifiers 1

IdentifierTypeStateIssuer
78012085MedicaidKY

Other names 1

  • Brenda J Terpin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4221PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Clinic, PLLC Past Accepting new patients
Paul E McLaughlin PastSince Jun 9, 2003 Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1609884287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7364",
            "fax_number": "502-568-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TATES CREEK RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405023408",
            "telephone_number": "859-266-2126",
            "fax_number": "859-266-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "BRENDA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4221P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78012085",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "TERPIN",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.