Active NPI
Brenda Mwesigwa, NP
- Nurse Practitioner
- Modesto, CA
National Provider Identifier
1669860110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP95004015
- Practice address
- 1409 E Briggsmore Ave
Modesto, CA 95355-2707 - Phone
- (209) 550-4750
- NPI assigned
- Jan 7, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP95004015 | CA | Primary |
| Orthopedic Registered Nurse | 163WX0800X | R 28506-5 | MN | |
| Gerontology Clinical Nurse Specialist | 364SG0600X | 3797 | MN |
Addresses
Primary practice location
1409 E Briggsmore Ave
Modesto, CA 95355-2707
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097
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
| License | State | Type | Specialty |
|---|---|---|---|
| R 28506-5 | MN | MD | Orthopedic Registered Nurse |
| 3797 | MN | MD | Athletic Trainer |
| NP95004015 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edencare Home Health Agency | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Concord, CA
- NPI 1073155875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1669860110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-521-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 E BRIGGSMORE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552707",
"telephone_number": "209-550-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MWESIGWA",
"first_name": "BRENDA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-07",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP95004015",
"primary": true
},
{
"code": "163WX0800X",
"taxonomy_group": "",
"desc": "Registered Nurse, Orthopedic",
"state": "MN",
"license": "R 28506-5",
"primary": false
},
{
"code": "364SG0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Gerontology",
"state": "MN",
"license": "3797",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.