Individual provider Active NPI

Brenda F. Look, PA

  • Physician Assistant
  • Eaton Rapids, MI
National Provider Identifier
1679504294
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601001729 Issued in MI
Practice address
101 E Spicerville Hwy # 100
Eaton Rapids, MI 48827-1919
Phone
(517) 663-1511
Fax
(517) 663-8844
NPI assigned
Jul 5, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601001729 MI Primary

Addresses

Primary practice location

101 E Spicerville Hwy # 100
Eaton Rapids, MI 48827-1919

Mailing address

PO Box 352
Mason, MI 48854-0352
Phone (517) 676-9788

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601001729MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Susan L. Courtnage, MD, PC Past 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, 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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679504294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540352",
            "telephone_number": "517-676-9788",
            "fax_number": "517-676-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E SPICERVILLE HWY # 100",
            "city": "EATON RAPIDS",
            "state": "MI",
            "postal_code": "488271919",
            "telephone_number": "517-663-1511",
            "fax_number": "517-663-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOK",
        "first_name": "BRENDA",
        "middle_name": "F.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eaton Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.