Individual provider Active NPI

Brenna Ashley Labere, MD

  • Allergy & Immunology Physician
  • Phoenix, AZ
National Provider Identifier
1952834368
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
67710 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-4063
Fax
(602) 933-2423
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10955741-1205 UT
Allergy & Immunology Physician 207K00000X 67710 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-1000

Other names 1

  • Brenna Ashley Benson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725002094 AZ Practitioner - Allergy/Immunology 9436403540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
67710AZMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients

Locations

6524 W Sack Dr
Ste 101
Glendale, AZ 85308

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

Organizations & group practices 2

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1952834368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-4063",
            "fax_number": "602-933-2423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Mario Capecchi Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841131103",
            "country_code": "US",
            "telephone_number": "801-662-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABERE",
        "first_name": "BRENNA",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "10955741-1205",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "67710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENNA",
            "last_name": "BENSON",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.