Individual provider Active NPI

Brenda S Brennan, APRN

  • Community Health Nurse Practitioner
  • Pittsburg, KS
National Provider Identifier
1619979440
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
License
44376 Issued in KS
Practice address
3011 N Michigan St
Pittsburg, KS 66762-2546
Phone
(620) 231-9873
Fax
(620) 231-2808
NPI assigned
Aug 11, 2005
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X 44376 KS Primary

Addresses

Primary practice location

3011 N Michigan St
Pittsburg, KS 66762-2546

Mailing address

PO Box 1832
Pittsburg, KS 66762-1832
Phone (620) 231-9873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816000509 KS Practitioner - Nurse Practitioner 3678503083 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44376KSMDCommunity Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Southeast Kansas Inc CurrentSince Jun 27, 2005 Accepting new patients
Community Health Center of Southeast Kansas Inc Current Accepting new patients
Community Health Center of Southeast Kansas, Inc CurrentSince Jun 27, 2005 Accepting new patients
Community Health Center of Southeast Kansas, Inc Past Accepting new patients
Olathe Health Physicians, Inc. Past Accepting new patients
Medicalodges, Inc. Past Accepting new patients

Locations

1017 E Market St
Lacygne, KS 66040
Phone (913) 757-4575

3011 N Michigan St
Pittsburg, KS 66762
Phone (620) 231-1960

Interoperability endpoints

  • Direct secure messaging: brenda.brennan@khindirect.org

Organizations & group practices 6

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1619979440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832",
            "telephone_number": "620-231-9873",
            "fax_number": "620-231-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 N MICHIGAN ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622546",
            "telephone_number": "620-231-9873",
            "fax_number": "620-231-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "BRENDA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "KS",
            "license": "44376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

Verify at the official NPI Registry.