Individual provider Active NPI

Selena Maree Brennan, ATC

  • Athletic Trainer
  • Glendale, AZ
National Provider Identifier
1760149652
Registry record updated Nov 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000042251 Issued in MI
Practice address
9305 W Georgia Ave
Glendale, AZ 85305-3332
Phone
(248) 563-3314
NPI assigned
Nov 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X MI
Athletic Trainer 2255A2300X 2000042251 MI Primary

Addresses

Primary practice location

9305 W Georgia Ave
Glendale, AZ 85305-3332

Mailing address

9305 W Georgia Ave
Glendale, AZ 85305-3332
Phone (248) 563-3314

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
2000042251MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1760149652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 W GEORGIA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053332",
            "telephone_number": "248-563-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 W GEORGIA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053332",
            "telephone_number": "248-563-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "SELENA",
        "middle_name": "MAREE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-26",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2000042251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2025; 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.