Active NPI
Maryann Brenneman, AUD
- Audiologist
- Springfield, OH
National Provider Identifier
1861506149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A-0451
- Practice address
- 435 S Burnett Rd
Springfield, OH 45505-2717 - Phone
- (937) 325-8796
- Fax
- (937) 325-3640
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A-0451 | OH | Primary |
Addresses
Primary practice location
435 S Burnett Rd
Springfield, OH 45505-2717
Mailing address
435 S Burnett Rd
Springfield, OH 45505-2717
Phone (937) 325-8796
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000009377 | Other | OH | ANTHEM BLUE CROSS |
| 2373506 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-0451 | OH | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861506149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "435 S BURNETT RD",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455052717",
"telephone_number": "937-325-8796",
"fax_number": "937-325-3640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 S BURNETT RD",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455052717",
"telephone_number": "937-325-8796",
"fax_number": "937-325-3640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNEMAN",
"first_name": "MARYANN",
"name_prefix": "Mrs.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OH",
"license": "A-0451",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "000000009377",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2373506",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.