BRENDEN BRUNNER (NPI# 1659768588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659768588 |
| Entity Type | Individual |
| Full Name | BRENDEN BRUNNER |
| Credential | MD |
| Practice Address |
2551 Greenwood Rd Ste 410 Shreveport LA 71103-3989 |
| Mailing Address |
1202 Louisiana Ave Shreveport LA 71101-3910 |
| Practice Telephone | 3186212929 |
| Practice Fax Number | 3186212930 |
| Mailing Telephone | 3182128951 |
| Mailing Fax Number | 3182126752 |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2019-05-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD.309290 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2387952 | 05 |
| Street Address |
2551 GREENWOOD RD STE 410 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184687212 | Huan Q Le | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2006-04-10 |
| 1790397586 | Jennifer Grisham | Nurse Practitioner | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2020-08-21 |
| 1801328034 | Mohammad-hesam Akbarian-tefaghi | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2017-03-28 |
| 1063876068 | Derek Rey Munoz | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103 | 2016-04-06 |
| 1700273612 | Michael Broadwell | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2015-04-17 |
| 1134516172 | Kurtis Kostan | Hospitalist | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2015-04-16 |
| 1437579455 | Jared Mcfarlin | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2014-04-17 |
| 1063831352 | David M. Hudson | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2014-04-15 |
| 1861659062 | Matthew Frank | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2008-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790315026 | Cody Tingle Md LLC | Internal Medicine | 535 Pierremont Rd, Shreveport, LA 71106-2207 | 2020-01-26 |
| 1538654306 | Masri Group LLC | Internal Medicine | 3801 Creswell Ave Unit 19, Shreveport, LA 71106-1257 | 2018-06-25 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1760923064 | Martin Marak | Internal Medicine | 847 Prospect St, Shreveport, LA 71104-3025 | 2017-03-20 |
| 1265883482 | Vari LLC | Internal Medicine | 506 Rock Hollow Dr, Shreveport, LA 71115-2502 | 2016-06-29 |
| 1598140121 | Mihir V Patel Md LLC | Internal Medicine | 9930 Loveland Ct, Shreveport, LA 71106-7795 | 2015-07-24 |
| 1619357209 | Chad Michael Gibson | Internal Medicine | 8001 Youree Dr Ste 4007, Shreveport, LA 71115-2302 | 2015-06-09 |
| 1265829394 | Amanda Lynn Callegan-poche' | Internal Medicine | 1023 Provenance Pl Ste 130, Shreveport, LA 71106-7796 | 2015-04-15 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1477807980 | Ronald Baylis George | Internal Medicine | 1821 Willow Point Drive, Shreveport, LA 71119 | 2012-11-06 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
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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.