Individual provider Active NPI

John T Brennan, MD

  • Family Medicine Physician
  • Onalaska, WI
National Provider Identifier
1891776977
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16368 Issued in WI
Practice address
191 Theater Rd
Onalaska, WI 54650
Phone
(608) 785-0940
NPI assigned
Nov 7, 2005
Last updated
Jun 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 16368 WI
Emergency Medicine Physician 207P00000X 21682 MN
Family Medicine Physician 207Q00000X 16368 WI Primary
Internal Medicine Physician 207R00000X 16368 WI

Addresses

Primary practice location

191 Theater Rd
Onalaska, WI 54650

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-5222

Other practice location 1

800 West Ave S
LA Crosse, WI 54601-8806
Phone (608) 785-0940

Other practice location 2

325 Butts Ave
Tomah, WI 54660-1412
Phone (608) 785-0940

Other practice location 3

325 Butts Ave
Tomah, WI 54660-1412
Phone (608) 785-0940

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

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1891776977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATER RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546018806",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "fax_number": "608-269-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Butts Ave",
            "address_purpose": "LOCATION",
            "city": "Tomah",
            "state": "WI",
            "postal_code": "546601412",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Butts Ave",
            "address_purpose": "LOCATION",
            "city": "Tomah",
            "state": "WI",
            "postal_code": "546601412",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "16368",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "21682",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "16368",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "16368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.