Active NPI
James Michael Brennan, M.D.
- Obstetrics & Gynecology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MDR6C99
- Practice address
- 12700 Southfork Rd
Ste 230
Saint Louis, MO 63128-3201 - Phone
- (314) 849-3711
- Fax
- (314) 849-0235
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MDR6C99 | MO | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 336-069065 | IL |
Addresses
Primary practice location
12700 Southfork Rd
Ste 230
Saint Louis, MO 63128-3201
Mailing address
12700 Southfork Rd
Ste 230
Saint Louis, MO 63128-3201
Phone (314) 849-3711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202125209 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 336-069065 | IL | MD | Obstetrics & Gynecology Physician |
| MDR6C99 | MO | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic East Communities | Current | Accepting new patients | |
| Mercy Clinic East Communities | Obstetrics & Gynecology | Current | Accepting new patients |
| Brennan OB GYN Associate, P.C. | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
1011 Bowles Ave
Ste 425
Fenton, MO 63026
Phone (636) 326-2600
5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
12700 Southfork Rd
Ste 230
Saint Louis, MO 63128
Phone (314) 525-4880
13023 Tesson Ferry Rd
Ste 103
Saint Louis, MO 63128
Phone (314) 849-3711
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1851335228
Obstetrics & Gynecology
-
- Obstetrics & Gynecology Physician
- Saint Louis, MO
- NPI 1568578235
-
- Family Medicine Physician
- Saint Louis, MO
- NPI 1720635329
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": "1489449600000",
"number": "1699714360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12700 SOUTHFORK RD",
"address_2": "STE 230",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631283201",
"telephone_number": "314-849-3711",
"fax_number": "314-849-0235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12700 SOUTHFORK RD",
"address_2": "STE 230",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631283201",
"telephone_number": "314-849-3711",
"fax_number": "314-849-0235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "JAMES",
"middle_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2017-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "MDR6C99",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "336-069065",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202125209",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.