DR. RYAN J. BRENZA (NPI# 1356331854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356331854 |
| Entity Type | Individual |
| Full Name | DR. RYAN J. BRENZA |
| Credential | D.O. |
| Practice Address |
4901e Johnson Ave Jonesboro AR 72401-8417 |
| Mailing Address |
Po Box 1960 Jonesboro AR 72403-1960 |
| Practice Telephone | 8709328222 |
| Practice Fax Number | 8709343455 |
| Mailing Telephone | 8709328222 |
| Mailing Fax Number | 8709343455 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2015-12-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | E-6825 | AR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 47860 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
4901E JOHNSON AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-8417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708641 | Premiere Family Practice | Family Medicine | 1904 Grant Ave Ste G, Jonesboro, AR 72401-6165 | 2020-10-22 |
| 1760003248 | New York Institute of Technology | Family Medicine | 333b Red Wolf Blvd, Jonesboro, AR 72405-9739 | 2020-05-06 |
| 1548814031 | H&h Wellness Clinic | Family Medicine | 7000 Tara Blvd Ste C, Jonesboro, GA 30236-1600 | 2019-08-01 |
| 1518466739 | Trinity Wellness Center, LLC. | Family Medicine | 9434 S Main St Ste 1100, Jonesboro, GA 30236-6092 | 2018-02-02 |
| 1003343864 | Men & Womens Premier Health Solutions Pa | Family Medicine | 3410 E Johnson Ave Ste T, Jonesboro, AR 72401-1876 | 2017-05-11 |
| 1891231403 | Stacy Wilbanks Md Plc | Family Medicine | 3100 Southern Hills Ln, Jonesboro, AR 72401-8048 | 2017-01-06 |
| 1992164750 | Doctors Health Group, Inc | Family Medicine | 3637b E Johnson Ave, Jonesboro, AR 72401-1808 | 2016-02-22 |
| 1245605278 | Family Physicians of Jonesboro | Family Medicine | 3104 Apache Dr, Jonesboro, AR 72401-7405 | 2015-12-02 |
| 1669856704 | Medical Rehab Group LLP | Family Medicine | 1201 Fleming, Jonesboro, AR 72401 | 2015-07-18 |
| 1487049953 | Ali Haydar | Family Medicine | 4909 E Johnson Ave, Jonesboro, AR 72401-8417 | 2015-04-01 |
| Find all providers in JONESBORO | ||||
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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.