Individual provider Active NPI

Kaitlen Irene Brennan, LAC

  • Acupuncturist
  • Saint Paul, MN
National Provider Identifier
1922542661
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1790 Issued in MN
Practice address
1032 Grand Ave
Saint Paul, MN 55105-3064
Phone
(651) 227-6865
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1790 MN Primary

Addresses

Primary practice location

1032 Grand Ave
Saint Paul, MN 55105-3064

Mailing address

1053 Fairmount Ave
Saint Paul, MN 55105-3123
Phone (651) 206-8005

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1790MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
French Made Inc Acupuncturist Past Accepting new patients

Organizations & group practices 1

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": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1922542661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 FAIRMOUNT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053123",
            "telephone_number": "651-206-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053064",
            "telephone_number": "651-227-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "KAITLEN",
        "middle_name": "IRENE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.