Organization Active NPI

Jamie L Brenon DC PLLC

  • Chiropractor
  • Tonawanda, NY
National Provider Identifier
1912203456
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
010040 Issued in NY
Legal business name
JAMIE L BRENON DC PLLC
Practice address
1088 Brighton Rd
Tonawanda, NY 14150-8309
Phone
(716) 837-1711
NPI assigned
Feb 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Authorized official

Name
Jamie BrenonNPI 1033230610
Title
Owner
Phone
(716) 837-1711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 010040 NY Primary

Addresses

Primary practice location

1088 Brighton Rd
Tonawanda, NY 14150-8309

Mailing address

1088 Brighton Rd
Tonawanda, NY 14150-8309
Phone (716) 837-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110211000127 NY Part B Supplier - Clinic/Group Practice 5991985798 Receives reassigned benefits from 3 practitioners
Practice locations: Tonawanda, NY

National Provider Directory

National Provider Directory

Locations

1088 Brighton Rd
Tonawanda, NY 14150
Phone (716) 837-1711

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1912203456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508309",
            "telephone_number": "716-837-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508309",
            "telephone_number": "716-837-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMIE L BRENON DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "BRENON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-837-1711"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "010040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.