Kent Brandeberry (NPI# 1629164728, PAC ID# 9234364761) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1629164728 |
| PAC ID by PECOS | 9234364761 |
| Professional Enrollment ID | I20131108000748 |
| Full Name | Kent Brandeberry |
| Organization Legal Name | MERCY HEALTH PHYSICIANS LIMA, LLC |
| Address |
3224 Jarvis Dr Lima OH 45807 |
| Phone Number | 4199965757 |
| Gender | M |
| Medical School | OHIO UNIVERSITY OF OSTEO MEDICINE |
| Graduation Year | 2006 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 3375607351 |
| Number of Group Practice Members | 215 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360066 | ST RITA'S MEDICAL CENTER |
| 360009 | LIMA MEMORIAL HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 3224 Jarvis Dr, Lima, OH 45807 | 4199965757 | MERCY HEALTH PHYSICIANS LIMA, LLC |
| Organization Legal Name | MERCY HEALTH PHYSICIANS LIMA, LLC |
| Physicians | 190 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Ann Beckett-avery | Clinical Social Worker | Mercy Health Physicians Lima, LLC | 582 N Cable Rd, Lima, OH 45805-2133 |
| Stephanie L Rodriguez | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 967 Bellefontaine Ave, Lima, OH 45804-2888 |
| Dale W Case | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 2195 Allentown Rd, Lima, OH 45805-1705 |
| Jami J Blackburn | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 2745 Fort Amanda Rd, Lima, OH 45805-4805 |
| Jessica England | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 604 W N Ave, Ada, OH 45810-1041 |
| Danielle R Westrick | Family Medicine | Mercy Health Physicians Lima, LLC | 1800 E 5th St, Suite 1, Delphos, OH 45833-9180 |
| Brenda K Fish | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 3224 Jarvis Dr, Lima, OH 45807 |
| Garrison Vasile Morin | Otolaryngology | Mercy Health Physicians Lima, LLC | 770 W High St, Suite 460, Lima, OH 45801-5908 |
| Anil K Muddada | Nephrology | Mercy Health Physicians Lima, LLC | 1207 E Columbus St, Kenton, OH 43326-1760 |
| Susan E Hamilton | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 803 W Market St, Suite 200, Lima, OH 45805-2796 |
| Street Address |
3224 JARVIS DR |
| City | LIMA |
| State | OH |
| Zip | 45807 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brenda K Fish | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 3224 Jarvis Dr, Lima, OH 45807 |
| Jan M Schroeder | Nurse Practitioner | Mercy Health Physicians Lima, LLC | 3224 Jarvis Dr, Lima, OH 45807 |
| Mark D. Kahle | Family Medicine | Mercy Health Physicians Lima, LLC | 3224 Jarvis Dr, Lima, OH 45807 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Todd R Bullinger | Chiropractic | 415 E Kiracofe Ave, Elida, OH 45807-1031 | |
| James Theodore Bowlus | Family Medicine | 610 E Kiracofe Ave, Elida, OH 45807-1034 | |
| Jonathan Laux | Chiropractic | 4030 Allentown Rd, Lima, OH 45807-2146 | |
| Sheri Lynn Miller | Nurse Practitioner | Gastroenterology of West Central Ohio, Inc. | 375 N Eastown Rd, Suite A, Lima, OH 45807-2209 |
| Marilyn E Roberts | Nurse Practitioner | Lima Memorial Professional Corporation | 525 N Eastown Rd, Suite A, Lima, OH 45807-2268 |
| Farnaz Mohammadi | Nephrology | Lima Memorial Professional Corporation | 525 N Eastown Rd, Lima, OH 45807-2268 |
| Xiusheng Qin | Internal Medicine | Lima Memorial Professional Corporation | 525 N Eastown Rd, Suite A, Lima, OH 45807-2268 |
| Glenn A Bryant Iii | Internal Medicine | Lima Memorial Professional Corporation | 525 N Eastown Rd, Lima, OH 45807-2268 |
| Emmanuel J Tabora | Family Practice | Lima Memorial Professional Corporation | 525 N Eastown Rd, Suite A, Lima, OH 45807-2268 |
| City | LIMA |
| Zip Code | 45807 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LIMA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Kent Brandeberry.
| 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.