Tierney Brennan

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP016028 Issued in PA

Practice address

464 Inveraray Rd
Villanova, PA 19085-1138

Phone

(630) 640-1167

NPI assigned

Apr 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1831553023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 INVERARAY RD",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851138",
            "telephone_number": "630-640-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 INVERARAY RD",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851138",
            "telephone_number": "630-640-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "TIERNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP016028",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209014087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prashant Bhandare, MD
• Ty Bigelow, DAT, MBA, LAT, ATC
• James N Black, MD
• Cheryl Borck-Hadley, MSW
• Lee A. Bowers, PH.D.
• Valerie Amoss Brill, PT
• Bernard Alan Brownstein, MD
• Bryn Mawr Dermatology, P.C.
• Cathy Buch, MD
• Edward C Burnetta, M.D.

• Pediatric Nurse Practitioner in Villanova, PA
• Providers in Villanova, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.