Individual provider Active NPI

Joan Marie Brncich, RN.FA

  • Registered Nurse First Assistant
  • Joliet, IL
National Provider Identifier
1730343815
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
041236998 Issued in IL
Practice address
1300 Copperfield Ave
Suite 4040
Joliet, IL 60432-2004
Phone
(815) 727-3030
Fax
(815) 740-4964
NPI assigned
Jul 17, 2008
Last updated
Jul 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 041236998 IL Primary

Addresses

Primary practice location

1300 Copperfield Ave
Suite 4040
Joliet, IL 60432-2004

Mailing address

1300 Copperfield Ave
Suite 4040
Joliet, IL 60432-2004
Phone (815) 727-3030

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041236998ILMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Orthopaedic Group S C 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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1730343815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 COPPERFIELD AVE",
            "address_2": "SUITE 4040",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322004",
            "telephone_number": "815-727-3030",
            "fax_number": "815-740-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 COPPERFIELD AVE",
            "address_2": "SUITE 4040",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322004",
            "telephone_number": "815-727-3030",
            "fax_number": "815-740-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRNCICH",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "credential": "RN.FA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IL",
            "license": "041236998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.