MARIELLE ALYSSA BRENNER (NPI# 1508398124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508398124 |
| Entity Type | Individual |
| Full Name | MARIELLE ALYSSA BRENNER |
| Credential | MD |
| Practice Address |
1701 N Senate Ave Indianapolis IN 46202-5306 |
| Mailing Address |
705 Riley Hospital Dr Rm 1803 Indianapolis IN 46202-5109 |
| Practice Telephone | 3179441952 |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 01083722A | IN | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 7025520 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300037013 | 05 |
| Street Address |
1701 N SENATE AVE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46202-5306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275533010 | Alexander Mao Yeh | Radiology | 1701 N Senate Ave, Radiation Therapy, Indianapolis, IN 46202-5306 | 2005-07-22 |
| 1962002238 | Brittany Taylor Frees | Nurse Practitioner | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2020-10-27 |
| 1609473081 | Robert Garland Green Jr. | Pharmacist | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2020-10-08 |
| 1174131445 | Lauren Dickerson | Pharmacist | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2020-07-22 |
| 1710506407 | Monika Tilmans | Student in an Organized Health Care Education/Training Program | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2020-04-13 |
| 1790304632 | Patrick Donald Wurster | Student in an Organized Health Care Education/Training Program | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2020-04-10 |
| 1447890074 | Amanda Van Milligan | Counselor | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2020-01-12 |
| 1912543281 | Eric Brassfield | Pharmacist | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2019-11-21 |
| 1255984597 | Lindsay Perius | Physician Assistant | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2019-07-16 |
| 1861057176 | Tiffany Rader | Clinical Nurse Specialist | 1701 N Senate Ave, Indianapolis, IN 46202-5306 | 2019-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
| 1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
| 1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
| 1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
| 1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
| Find all providers in zip 46202 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508358128 | Antonino Bucca | Emergency Medicine | 720 Eskenazi Ave Bldg 3, Indianapolis, IN 46202-5187 | 2018-05-30 |
| 1124518931 | Evan Mitchell Landry Tomkiewicz | Emergency Medicine | 720 Eskenazi Ave Fl Ft3, Indianapolis, IN 46202-5187 | 2018-05-16 |
| 1114307063 | Grant Fabian Chernoby | Emergency Medicine | 701 N Senate Ave # B401, Indianapolis, IN 46202-3111 | 2015-06-05 |
| 1508203514 | Mark Liao | Emergency Medicine | 1701 N Senate Blvd Rm Ag012, Indianapolis, IN 46202-1239 | 2013-05-30 |
| 1003157322 | Medexpress Urgent Care PC - Indiana | Emergency Medicine | 10863 E Washington St, Indianapolis, IN 46229-2615 | 2013-03-12 |
| 1164763744 | Medexpress Urgent Care PC - Indiana | Emergency Medicine | 4903 S Emerson Ave, Indianapolis, IN 46203-5938 | 2013-03-07 |
| 1205199379 | Damien T Berry | Emergency Medicine | 6335 S East St, Indianapolis, IN 46227-7112 | 2012-06-22 |
| 1972886422 | Barber Hospital LLC | Emergency Medicine | 8125 Knue Rd, Indianapolis, IN 46250-1936 | 2011-09-21 |
| 1225321797 | Seth Benjamin Langsam | Emergency Medicine | 1120 W Michigan St, Cl 260, Indianapolis, IN 46202-5209 | 2011-05-17 |
| 1538480777 | Stephanie M Gardner | Emergency Medicine | 5262 Carrollton Ave, Indianapolis, IN 46220-3181 | 2010-06-22 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46202 |
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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.