Active NPI
Elizabeth Marie Brennan, M.D.
- Pediatrics Physician
- St Petersburg, FL
National Provider Identifier
1720101397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME104203
- Practice address
- 601 5TH St S Dept 6941
St Petersburg, FL 33701 - Phone
- (727) 767-8480
- Fax
- (727) 767-8420
- NPI assigned
- Apr 9, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | D59277 | MD | |
| Pediatrics Physician | 208000000X | ME104203 | FL | Primary |
Addresses
Primary practice location
601 5TH St S Dept 6941
St Petersburg, FL 33701
Mailing address
601 5TH St S Dept 6941
St Petersburg, FL 33701
Phone (727) 767-8480
Other names 1
- Dr. Elizabeth Marie Brennan
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME104203 | FL | MD | Pediatrics Physician |
| D59277 | MD | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Physician Services, Inc. | Pediatrics | Past | Accepting new patients |
| Cedar Health Ventures, LLC | Past | Accepting new patients |
Interoperability endpoints
- ebrennan732899@direct.hopkinsmedicine.org
Organizations & group practices 2
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.
-
- Pediatrics Physician
- St Petersburg, FL
- NPI 1770532798
-
- Emergency Medicine Physician
- Columbia, MD
- NPI 1114931417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1720101397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 5TH ST S DEPT 6941",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33701",
"telephone_number": "727-767-8480",
"fax_number": "727-767-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 5TH ST S DEPT 6941",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33701",
"telephone_number": "727-767-8480",
"fax_number": "727-767-8420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "ELIZABETH",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MD",
"license": "D59277",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME104203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "BRENNAN",
"middle_name": "MARIE",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.