Kelley Grayson Brenner (NPI# 1689843054, PAC ID# 5597818385) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1689843054 |
| PAC ID by PECOS | 5597818385 |
| Professional Enrollment ID | I20150320000657 |
| Full Name | Kelley Grayson Brenner |
| Organization Legal Name | FAMILY PRACTICE ST CLOUD PA |
| Address |
3100 17th St Saint Cloud FL 34769-6021 |
| Phone Number | 4078913500 |
| Gender | F |
| Graduation Year | 2007 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3274432521 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100302 | ST CLOUD REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3100 17th St, Saint Cloud, FL 34769-6021 | 4078913500 | FAMILY PRACTICE ST CLOUD PA |
| Organization Legal Name | FAMILY PRACTICE ST CLOUD PA |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly R Stein | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Bethany Mcqueen | Nurse Practitioner | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Nikole Stephens | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Charles K Powers Jr. | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| David P Thorne | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Roshan K Patel | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| John Wilker | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Laura L Brooks | Nurse Practitioner | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Street Address |
3100 17TH ST |
| City | SAINT CLOUD |
| State | FL |
| Zip | 34769-6021 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly R Stein | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Bethany Mcqueen | Nurse Practitioner | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Nikole Stephens | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Charles K Powers Jr. | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| David P Thorne | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Roshan K Patel | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| John Wilker | Family Medicine | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Laura L Brooks | Nurse Practitioner | Family Practice St Cloud Pa | 3100 17th St, Saint Cloud, FL 34769-6021 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carmen Ana Sierra | Family Medicine | 4745 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | |
| Dustin N Ly | Internal Medicine | 4737 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | |
| Naga Lakshmana Prasad Nidadavolu | Neurology | 4739 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | |
| Steven L Petty | Chiropractic | Joint Maneuvers Chiropractic Centre Pa | 4797 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 |
| Brett E Petty | Chiropractic | Joint Maneuvers Chiropractic Centre Pa | 4797 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 |
| Ramarao Makkena | Psychiatry | Oglethorpe of Orlando Inc | 91 Beehive Cir, Saint Cloud, FL 34769-1432 |
| Amit R Desai | Psychiatry | Oglethorpe of Orlando Inc | 91 Beehive Cir, Saint Cloud, FL 34769-1432 |
| Jose A Flores Guevara | Ophthalmology | St Cloud Eye Center Inc | 4691 Old Canoe Creek Rd, Saint Cloud, FL 34769-1550 |
| Ly T Nguyen | Ophthalmology | St Cloud Eye Center Inc | 4691 Old Canoe Creek Rd, Saint Cloud, FL 34769-1550 |
| Elba E Masid | Family Medicine | 4513 Old Canoe Creek Rd, Saint Cloud, FL 34769-1551 | |
| Find all physicians in zip 34769 | |||
| City | SAINT CLOUD |
| Zip Code | 34769 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SAINT CLOUD + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Kelley Grayson Brenner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.