MR. CASEY BRENNAN (NPI# 1265900260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265900260 |
| Entity Type | Individual |
| Full Name | MR. CASEY BRENNAN |
| Practice Address |
200 Medical Park Blvd Petersburg VA 23805-9274 |
| Practice Telephone | 8047655000 |
| Mailing Telephone | 8047655000 |
| Mailing Fax Number | 8047655521 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2020-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
00241176871 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4723 Archduke Rd, Glen Allen, VA 230603646 | 8044021066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579028 | Casey Elizabeth Brennan | Occupational Therapist | 2237 N Hullen St Ste 202, Metairie, LA 70001-6913 | 2019-07-01 |
| Street Address |
200 MEDICAL PARK BLVD |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-9274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413636 | Delesa Shana Kay Walden | Registered Nurse | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-09-27 |
| 1992339436 | Amy Kathryn Lansing | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-02-24 |
| 1588296453 | Erin Elise Layne | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-02-10 |
| 1295374643 | Crystal Leigh Maddox | Physical Therapist | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-01-02 |
| 1366081911 | Joshua Paul Pidcoe | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-12-31 |
| 1720623853 | Bon Secours Mercy Health Petersburg LLC | General Acute Care Hospital | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-11-13 |
| 1144874686 | Nina Thi Ong-pham | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-08-01 |
| 1720543507 | Martina Rochelle Washington | Specialist/Technologist, Other | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-02-05 |
| 1356812242 | Ams Virginia Pllc | Nurse Anesthetist, Certified Registered | 200 Medical Park Blvd, Petersburg, VA 23805 | 2018-12-17 |
| 1841761079 | Erin Collins | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342895 | Stacey Reynolds Dahl | Nurse Practitioner | 103 Fram Treet, Petersburg, AK 99833-0589 | 2020-10-07 |
| 1992269286 | Angela Hooe | Nurse Practitioner | 601 Old Wagner Rd Ste 100, Petersburg, VA 23805-9313 | 2019-01-30 |
| 1902390982 | Haneefah Omega Henry Rhodes | Nurse Practitioner | Vsu Health Center 1 Hayden Dr, Petersburg, VA 23806-0001 | 2018-06-21 |
| 1265936454 | Angela Marie Jeter | Nurse Practitioner | 3471 Woolper Rd, Petersburg, KY 41080-9764 | 2018-03-21 |
| 1205347846 | Bethany Kinney | Nurse Practitioner | 4100 W Rauch Rd, Petersburg, MI 49270-9800 | 2017-10-23 |
| 1801244165 | Tonya Shah | Nurse Practitioner | 601 Old Wagner Rd Ste 101, Petersburg, VA 23805-9313 | 2016-05-27 |
| 1801146071 | Melissa Lee Mathias | Nurse Practitioner | 10 Mulligan Drive, Petersburg, WV 26847-1511 | 2012-09-14 |
| 1548411879 | Lynette Galloway Branch | Nurse Practitioner | Virginia State University Student Health, 1 Hayden Drive, Petersburg, VA 23806-0001 | 2008-10-06 |
| 1922215128 | Vicky Nell Groce | Nurse Practitioner | 212 South Public Square, Petersburg, TN 37144-0093 | 2007-05-17 |
| 1134298995 | Becky J Calhoun Harman | Nurse Practitioner | 100 Hospital Dr Ste 1, Petersburg, WV 26847 | 2006-11-07 |
| Find all providers in PETERSBURG | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.