{"npi":"1902324205","type":"NPI-1","status":"active","name":{"display":"Marissa Brennan PA-C","other":[{"code":"1","type":"Formerly known as","value":"TENNANT, MARISSA"}],"first":"MARISSA","last":"BRENNAN","credential":"PA-C"},"specialty":{"primary_taxonomy":"363AM0700X","primary_taxonomy_description":"Medical Physician Assistant","slug":"medical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":true,"state":"CT","license":"3987"},{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"RI","license":"PA01528"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"365 MONTAUK AVE","city":"NEW LONDON","state":"CT","postal_code":"063204700","country_code":"US","phone":"8602714364","fax":"8604445114"},{"purpose":"MAILING","street_1":"365 MONTAUK AVE","city":"NEW LONDON","state":"CT","postal_code":"063204700","country_code":"US","phone":"8602714364","fax":"8604445114"}],"license":{"state":"CT","number":"3987"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20180219001347","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"CT","pac_id":"3375804107"},{"enrlmt_id":"I20200428001655","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"RI","pac_id":"3375804107"}]},"enumeration_date":"2017-09-07","last_updated":"2025-09-04","_meta":{"source":"NPPES","snapshot_date":"2025-09-04","doc_url":"https://findmynpi.com/api"}}