MIKE BRENNER D.O.
NPI 1225497084
Student in an Organized Health Care Education/Training Program in Jackson, MI

Q: What is Mike Brenner's NPI number?

The NPI number for Mike Brenner is 1225497084. It was assigned to this individual provider in the NPPES registry on February 22, 2016.

Q: What is Mike Brenner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Mike Brenner was last updated on June 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 22, 2016PECOS Enrolled

205 N EAST AVE, JACKSON, MI 49201(517) 205-7164(517) 205-7050 Get Directions Write a Review

NPPES record last updated: June 20, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 20, 2018, Feb 22, 2016 (2 updates tracked since 2016).

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About Mike Brenner D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIKE BRENNER D.O. (NPI 1225497084) is an individual student in an organized health care education/training program in Jackson, Michigan and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225497084

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMIKE BRENNERCredential: D.O.

Location Address205 N EAST AVEJackson, MI 49201

Mailing Address205 N East AveJackson, MI 49201-1753 · (517) 205-7164 · Fax (517) 205-7050

Phone(517) 205-7164

Fax(517) 205-7050

Sole ProprietorNo

Enumeration DateFebruary 22, 2016

Last NPPES UpdateJune 20, 20182 updates tracked since enumeration

✔ NPI 1225497084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

205 N EAST AVE, Jackson, MI 49201

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mike Brenner D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA RENE DANEK PA-C

Physician Assistant