Kimberly Frances Brennan, CCMA

Primary specialty

TechnicianTaxonomy code 374700000X

License

D2X8X9MZ Issued in PA

Practice address

851 Commerce Blvd Ste 107
Dickson City, PA 18519-1762

Phone

(570) 489-5561

Fax

(570) 291-4473

NPI assigned

Jul 25, 2019

Last updated

Jul 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1689228967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 E MOUNTAIN RD",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052729",
            "telephone_number": "570-468-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 COMMERCE BLVD STE 107",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191762",
            "telephone_number": "570-489-5561",
            "fax_number": "570-291-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "KIMBERLY",
        "middle_name": "FRANCES",
        "credential": "CCMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "PA",
            "license": "D2X8X9MZ",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maura Brazil, M.S.
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• Laura Burns, OT R/L
• Gina Marie Calavano

• Technician in Dickson City, PA
• Providers in Dickson City, PA by specialty
• Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.