Individual provider Active NPI

Joel O Brende, MD

  • Psychiatry Physician
  • St. Joseph, MO
National Provider Identifier
1912109760
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2007008846 Issued in MO
Practice address
5325 Faraon St.
St. Joseph, MO 64506-3488
Phone
(816) 271-7273
Fax
(816) 271-7376
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 29002 AZ
Psychiatry Physician 2084P0800X 299002 AZ
Psychiatry Physician 2084P0800X 2007008846 MO Primary

Addresses

Primary practice location

5325 Faraon St.
St. Joseph, MO 64506-3488

Mailing address

5325 Faraon St.
St. Joseph, MO 64506-3488
Phone (816) 271-7273

Other identifiers 1

IdentifierTypeStateIssuer
053184MedicaidAZ

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

LicenseStateTypeSpecialty
299002AZMDPsychiatry Physician
2007008846MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pastoral Institute, Inc PastSince Aug 27, 1999 Accepting new patients
St Francis Health LLC Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1912109760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST.",
            "city": "ST. JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-7273",
            "fax_number": "816-271-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST.",
            "city": "ST. JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-7273",
            "fax_number": "816-271-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDE",
        "first_name": "JOEL",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "29002",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "299002",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2007008846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053184",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.