Individual provider Active NPI

Sheldon Sonnenberg, PT

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1245418870
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1174403 Issued in TX
Practice address
136 Glass St Ste 140
Dallas, TX 75207-6930
Phone
(469) 626-7254
Fax
(214) 237-1283
NPI assigned
Feb 6, 2008
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1174403 TX Primary

Addresses

Primary practice location

136 Glass St Ste 140
Dallas, TX 75207-6930

Mailing address

PO Box 127
Ballinger, TX 76821-0127
Phone (512) 850-5288

Other practice location 1

351 Cypress Creek Rd
Suite 203
Cedar Park, TX 78613-4528
Phone (512) 467-1100

Other identifiers 1

IdentifierTypeStateIssuer
1174403OtherTXTX LICENSE

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sheldon Sonnenberg Physical Therapist Current Accepting new patients
Human Function and Performance, LLC CurrentSince Jan 17, 2022 Accepting new patients
Innovative Physicians Past Accepting new patients

Locations

136 Glass St
Ste 140
Dallas, TX 75207
Phone (469) 405-1852

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1245418870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "BALLINGER",
            "state": "TX",
            "postal_code": "768210127",
            "telephone_number": "512-850-5288",
            "fax_number": "214-237-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 GLASS ST STE 140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752076930",
            "telephone_number": "469-626-7254",
            "fax_number": "214-237-1283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Cypress Creek Rd",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Cedar Park",
            "state": "TX",
            "postal_code": "786134528",
            "country_code": "US",
            "telephone_number": "512-467-1100",
            "fax_number": "512-467-1101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONNENBERG",
        "first_name": "SHELDON",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1174403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "1174403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.