Timothy Peter Brender, PPCNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

18189 Issued in CA

Practice address

480 Central Ave BLDG 1750
Jbphh, HI 96860-4908

Phone

(808) 471-5171

NPI assigned

Jul 9, 2008

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1740443746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE BLDG 1750",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "088-471-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE BLDG 1750",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-471-5171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Bldg H 100 Santa Margaritta Rd",
            "address_2": "Naval Hospital Camp Pendleton",
            "address_purpose": "LOCATION",
            "city": "Camp Pendleton",
            "state": "CA",
            "postal_code": "920555191",
            "country_code": "US",
            "telephone_number": "760-725-9457",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-9221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENDER",
        "first_name": "TIMOTHY",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "RN572397",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "18189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "572394",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER CERTIFICATE",
            "identifier": "18189",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Bennett, R.N.
• William P Boggess, D.M.D.
• Dustin Aldridge Bond, D.M.D.
• Benjamin Clemens Bowman
• Michael Braud
• Douglas Brook, IDMT
• Traci L. Brooks, RN, FNP-C
• James Bustamante
• Cory John Butler, IDC
• Daryl R Cadelina, RN

• Pediatric Nurse Practitioner in Jbphh, HI
• Providers in Jbphh, HI by specialty
• Pediatric Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.