Active NPI
Brendan Gerard Fennessy, MD
- Otolaryngology Physician
- Brewer, ME
National Provider Identifier
1851733075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MD20186
- Practice address
- 43 Whiting Hill Rd
Brewer, ME 04412-1005 - Phone
- (207) 973-5000
- Fax
- (207) 973-5042
- NPI assigned
- Jul 30, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD20186 | ME | Primary |
Addresses
Primary practice location
43 Whiting Hill Rd
Brewer, ME 04412-1005
Mailing address
885 Union St
Ste 145
Bangor, ME 04401-3083
Phone (207) 973-9595
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 |
|---|---|---|---|
| MD20186 | ME | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417132800000",
"number": "1851733075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 UNION ST",
"address_2": "STE 145",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013083",
"telephone_number": "207-973-9595",
"fax_number": "207-973-9595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 WHITING HILL RD",
"city": "BREWER",
"state": "ME",
"postal_code": "044121005",
"telephone_number": "207-973-5000",
"fax_number": "207-973-5042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNESSY",
"first_name": "BRENDAN",
"middle_name": "GERARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-30",
"last_updated": "2014-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "ME",
"license": "MD20186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewer, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.