DR. STEPHEN LOUIS BRENNEKE (NPI# 1194714303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194714303 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN LOUIS BRENNEKE |
| Credential | M.D. |
| Practice Address |
10121 Se Sunnyside Rd Suite 130 Clackamas OR 97015-5745 |
| Practice Telephone | 5037663545 |
| Practice Fax Number | 5033423766 |
| Mailing Telephone | 5037663545 |
| Mailing Fax Number | 5033423766 |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2011-03-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
MD11314 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE GROUP | 112187 | 01 |
| Street Address |
10121 SE SUNNYSIDE RD SUITE 130 |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-5745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144213133 | David Edward Doyle Jr. | Dentist | 10121 Se Sunnyside Rd, Suite 320, Clackamas, OR 97015-5745 | 2005-08-25 |
| 1346796752 | Jeanette Marie Brown-snyder | Physical Therapist | 10121 Se Sunnyside Rd, Suite 210, Clackamas, OR 97015-5745 | 2016-08-27 |
| 1194186072 | Samantha Ellen Richards | Speech-Language Pathologist | 10121 Se Sunnyside Rd, Suite 210, Clackamas, OR 97015-5745 | 2016-03-18 |
| 1477929776 | Advanced Home Health Northwest LLC | Home Health | 10121 Se Sunnyside Rd, Suite 210, Clackamas, OR 97015-5745 | 2015-08-20 |
| 1124412366 | Gaelen Watt | Physical Therapist | 10121 Se Sunnyside Rd, #208, Clackamas, OR 97015 | 2015-03-25 |
| 1902212731 | James M Mours LLC | Psychologist | 10121 Se Sunnyside Rd, Suite 300, Clackamas, OR 97015-5745 | 2014-07-01 |
| 1851715098 | James M Mours, LLC | Clinic/Center | 10121 Se Sunnyside Rd, Suite #300, Clackamas, OR 97015-5745 | 2014-02-07 |
| 1043648033 | Northwest Family Psychology | Psychologist | 10121 Se Sunnyside Rd, Suite 300, Clackamas, OR 97015-5745 | 2013-10-29 |
| 1538314109 | Align Chiropractic LLC | Clinic/Center | 10121 Se Sunnyside Rd, Suite #300, Clackamas, OR 97015-5745 | 2008-11-24 |
| 1164638136 | Kimberley Jane Horner | Naturopath | 10121 Se Sunnyside Rd, Suite 300b, Clackamas, OR 97015-5745 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194817569 | Seth Leopold Goldsmith | Orthopaedic Surgery | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548235377 | Steven Frederick Hoff | Orthopaedic Surgery | 5050 Ne Hoyt, Suite 660, Portland, OR 97213-2990 | 2006-02-23 |
| 1861495103 | James Robert Van Horne | Orthopaedic Surgery | 702 Ramsey Ave, Ste 112, Grants Pass, OR 97527-5572 | 2005-05-31 |
| 1851812689 | Sarah Brandt | Orthopaedic Surgery | 5050 Ne Hoyt St Ste 626, Portland, OR 97213-2956 | 2017-07-01 |
| 1669851721 | Isaac Obeng | Orthopaedic Surgery | 5050 Ne Hoyt St Ste 626, Portland, OR 97213-2956 | 2015-05-22 |
| 1407149487 | Daniel John Cowley | Orthopaedic Surgery | 537 Union Ave Fl 2, Grants Pass, OR 97527-5543 | 2011-05-24 |
| 1215227756 | Mark Eugene Mildren | Orthopaedic Surgery | 55 Coburg Rd, Eugene, OR 97401-2433 | 2011-04-18 |
| 1023307899 | Thomas Derek Kowalik | Orthopaedic Surgery | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914 | 2011-04-01 |
| 1619205440 | Portland Joint Reconstruction Clinic, P.C. | Orthopaedic Surgery | 5050 Ne Hoyt St, Suite 668, Portland, OR 97213-2991 | 2009-12-07 |
| 1457689028 | Arthritis & Joint Replacement Clinic, PC | Orthopaedic Surgery | 5050 Ne Hoyt St Ste 660, Portland, OR 97213-2990 | 2009-11-19 |
| 1720252810 | Thomas William Huff | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2008-04-18 |
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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.