Individual provider Active NPI

Charlette Brianna Brettl, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1952967499
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141448 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-4000
NPI assigned
May 9, 2019
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP141448 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Other identifiers 1

IdentifierTypeStateIssuer
1952967499MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210426001971 TX Practitioner - Nurse Practitioner 5597173831 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP141448TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TX, PLLC CurrentSince Jun 27, 2024 Accepting new patients
Maverick Emergency Medicine Associates PA CurrentSince Apr 13, 2021 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jun 1, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jun 1, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852
Phone (830) 733-5321

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Interoperability endpoints

  • Direct secure messaging: charlette.brettl.1@15777.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1952967499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETTL",
        "first_name": "CHARLETTE",
        "middle_name": "BRIANNA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952967499",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.