Jennifer Brennecke, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7826 Issued in ID

Practice address

6031 E Hootowl Dr
Boise, ID 83716-7168

Phone

(972) 352-8233

NPI assigned

Jan 18, 2022

Last updated

Jan 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1871244145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 E HOOTOWL DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837167168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 E HOOTOWL DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837167168",
            "telephone_number": "972-352-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNECKE",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT7826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jenny@revitalizestrength.com",
            "affiliation": "N",
            "address_1": "6031 E Hootowl Dr",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837167168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Elizabeth Breen
• Hayleigh Chrisann Breier, LMSW
• Stephanie Lynn Breilh, PA-C
• Stephanie Therese Breitenstein, LCPC
• Addison Jane Brekke
• Deanna Armenia Brent, LCSW
• Rebecca Breshears
• Tracey Carol Breski, LPC-6531
• Katie Linnae Bressler, MD
• Macy Alexandra Bressner

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.