Individual provider Active NPI

Sheldon Brumback

  • Behavior Technician
  • Murray, UT
National Provider Identifier
1235840752
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
404 E 4500 S Ste A34
Murray, UT 84107-2710
Phone
(801) 771-0273
NPI assigned
Dec 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

404 E 4500 S Ste A34
Murray, UT 84107-2710

Mailing address

787 E Raintree Ave
Sandy, UT 84094-5018
Phone (801) 414-7846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1235840752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 E RAINTREE AVE",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840945018",
            "telephone_number": "801-414-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E 4500 S STE A34",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841072710",
            "telephone_number": "801-771-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBACK",
        "first_name": "SHELDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.