NPIMap

Individual provider Active NPI

Brenna Nicole Carlson, PA-C

  • Medical Physician Assistant
  • Kansas City, MO
National Provider Identifier
1689201113
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2023039436 Issued in MO
Practice address
2211 Charlotte St Ste 150
Kansas City, MO 64108-2733
Phone
(816) 404-7030
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2023039436 MO Primary
Medical Physician Assistant 363AM0700X 001012109 NC
Medical Physician Assistant 363AM0700X 2522 NE

Addresses

Primary practice location

2211 Charlotte St Ste 150
Kansas City, MO 64108-2733

Mailing address

2211 Charlotte St
Kansas City, MO 64108-2733

Other practice location 1

2510 Bellevue Medical Center Dr Ste 145A
Bellevue, NE 68123-1556
Phone (402) 779-7207

Other practice location 2

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694
Phone (919) 235-6410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200914002903 NE Practitioner - Physician Assistant 2961820568 Reassigns benefits to 1 organization
I20231229000281 MO Practitioner - Physician Assistant 2961820568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truman Medical Center IncorporatedGroup PAC ID 7315841418, 237 clinicians

Practice addresses (Care Compare)

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-7000

Hospital & facility affiliations

  • Truman Medical Center Hospital Hill Hospital, Kansas City, MO, CCN 260048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2023039436MOMDMedical Physician Assistant
001012109NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Truman Medical Center, Incorporated CurrentSince Jan 22, 2024 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Truman Medical Center, Incorporated CurrentSince Jan 22, 2024 Accepting new patients
Truman Medical Centers, Inc. Past Accepting new patients

Locations

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

2211 Charlotte St
Kansas City, MO 64108
Phone (816) 404-4966

2301 Holmes St
Kansas City, MO 64108

2211 Charlotte St
Ste 150
Kansas City, MO 64108
Phone (816) 404-7030

Interoperability endpoints

  • Direct secure messaging: bcarlson413712@directhisp.wakemed.org

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1689201113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 CHARLOTTE ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 CHARLOTTE ST STE 150",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082733",
            "telephone_number": "816-404-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 Bellevue Medical Center Dr Ste 145A",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "NE",
            "postal_code": "681231556",
            "country_code": "US",
            "telephone_number": "402-779-7207",
            "fax_number": "402-779-7210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "231 N Judd Pkwy NE",
            "address_purpose": "LOCATION",
            "city": "Fuquay Varina",
            "state": "NC",
            "postal_code": "275262694",
            "country_code": "US",
            "telephone_number": "919-235-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "BRENNA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2023039436",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001012109",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.