PETER A. BRENNER (NPI# 1659310563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659310563 |
| Entity Type | Individual |
| Full Name | PETER A. BRENNER |
| Credential | M.D. |
| Practice Address |
1350 Cleveland St Greenville SC 29607-2408 |
| Mailing Address |
7 Independence Pt Suite 140 Greenville SC 29615-4566 |
| Practice Telephone | 8642711450 |
| Mailing Telephone | 8647976044 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 7125 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | BCBS OF SC | 57-1004971003 | 01 |
| SC | 071255 | 05 | |
| SC | AETNA | 4556601 | 01 |
| Street Address |
1350 CLEVELAND ST |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29607-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083256382 | Crystal Beacham | Pediatrics | 1350 Cleveland St, Greenville, SC 29607-2440 | 2019-10-08 |
| 1376192641 | Maria Jay Mcdaniel | Clinical Neuropsychologist | 1350 Cleveland St, Greenville, SC 29607-2440 | 2019-09-09 |
| 1962978312 | Kara Petruzzelli | Dietitian, Registered | 1350 Cleveland St, Greenville, SC 29607-2440 | 2018-10-23 |
| 1831626738 | Deborah Ann Hutcheon | Dietitian, Registered | 1350 Cleveland St, Greenville, SC 29607-2440 | 2017-05-23 |
| 1639542665 | Bethany Motes Suddreth | Dietitian, Registered | 1350 Cleveland St, Greenville, SC 29607-2440 | 2015-11-13 |
| 1215318720 | Kristan Stewart Brown | Dietitian, Registered | 1350 Cleveland St, Greenville, SC 29607-2440 | 2015-06-11 |
| 1912301581 | Amanda Brooke Boatwright | Nurse Practitioner | 1350 Cleveland St, Greenville, SC 29607-2440 | 2014-10-10 |
| 1306193123 | Alternative Youth Services, Inc. | Foster Care Agency | 1350 Cleveland St, Suite B, Greenville, SC 29607-2440 | 2012-08-10 |
| 1053601435 | Florence Licheng Lee | Emergency Medicine | 1350 Cleveland St, Greenville, SC 29607-2440 | 2011-04-19 |
| 1093951311 | Robert Blake Windsor | Pediatrics | 1350 Cleveland St, Greenville, SC 29607-2440 | 2008-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846138 | Personalized Home Care Services | Technician | 1200 Woodruff Rd A3 Ste 150, Greenville, SC 29607 | 2020-09-16 |
| 1396361960 | Complete Homecare of America, Inc. | In Home Supportive Care | 128 Millport Circle, Suite 200, Greenville, SC 29607 | 2020-06-19 |
| 1275175093 | Carrie Laxton Ballenger | Nurse Practitioner | 2094 Woodruff Road, Greenville, SC 29607 | 2019-10-14 |
| 1861047037 | Susannah Long | Marriage & Family Therapist | 109 Laurens Road, Building 4 Ste D, Greenville, SC 29607 | 2019-08-05 |
| 1043872369 | Cheryl Craig Rosemond | Case Manager/Care Coordinator | 5 Century Drive, Suite 130, Greenville, SC 29607 | 2019-07-08 |
| 1457916561 | After Hours Chiropractic LLC | Chiropractor | 1200 Woodruff Rd Blg A-3, Simpsonville, SC 29607 | 2019-05-03 |
| 1952865289 | Orthodontic Specialists of Carolina, PC | Dentist | 611 Haywood Road, Greenville, SC 29607 | 2019-01-31 |
| 1124502307 | Martha Irby | Home Health Aide | 2320 E North St Rr 107, Greenville, SC 29607 | 2018-09-24 |
| 1780164541 | Suval Psychiatric Services, Pa | Clinic/Center | 33 Market Point Dr Ste 2023, Greenville, SC 29607 | 2018-08-20 |
| 1083113963 | Caroline Graham | Nurse Practitioner | 850 S Pleasantburg Dr, Greenville, SC 29607 | 2018-02-06 |
| Find all providers in zip 29607 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609380278 | Sarah Rider Grubbs | Pediatrics | 58 Park Vista Way, Greenville, SC 29617-7939 | 2017-11-18 |
| 1679005409 | Shailesh Manandhar | Pediatrics | 2816 Holly Glen Dr Apt A, Greenville, NC 27834-0064 | 2017-03-30 |
| 1114377645 | Madison Leigh Merritt | Pediatrics | 415 Duncan Chapel Rd, Greenville, SC 29617-8224 | 2016-06-15 |
| 1699139089 | Hunter Utkov Altman | Pediatrics | 701 Grove Road/ob Residency, Greenville, SC 29605-4210 | 2016-04-11 |
| 1851771976 | Ranjith Kasanagottu | Pediatrics | 200 Patewood Dr # A, Greenville, SC 29615-3593 | 2015-06-03 |
| 1336551365 | Sarah Rose Mangum Needham | Pediatrics | 709 Chesapeake Pl, Greenville, NC 27858-6236 | 2014-05-26 |
| 1124466164 | Katherine Marie Richardson | Pediatrics | 200 Patewood Drive Suite A200, Greenville, SC 29615-3580 | 2013-06-12 |
| 1689916264 | Shannon Nicole James | Pediatrics | 703 Verdae Blvd, Greenville, SC 29607 | 2013-03-21 |
| 1346411592 | Smithfield Pediatrics | Pediatrics | 7 Smith Avenue, Suite 103, Greenville, RI 02828 | 2008-03-16 |
| 1558546366 | Childrens Community Care | Pediatrics | 90 Shenango St Ste 12, Greenville, PA 16125-2060 | 2007-12-31 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29607 |
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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.