Active NPI
Peter A. Brenner, M.D.
- Pediatrics Physician
- Greenville, SC
National Provider Identifier
1659310563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 7125
- Practice address
- 1350 Cleveland St
Greenville, SC 29607-2408 - Phone
- (864) 271-1450
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 7125 | SC | Primary |
Addresses
Primary practice location
1350 Cleveland St
Greenville, SC 29607-2408
Mailing address
7 Independence PT
Suite 140
Greenville, SC 29615-4566
Phone (864) 797-6044
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071255 | Medicaid | SC | |
| 57-1004971003 | Other | SC | BCBS OF SC |
| 4556601 | Other | SC | AETNA |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1659310563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 INDEPENDENCE PT",
"address_2": "SUITE 140",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154566",
"telephone_number": "864-797-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 CLEVELAND ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296072408",
"telephone_number": "864-271-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "PETER",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "7125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071255",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF SC",
"identifier": "57-1004971003",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4556601",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.