Individual provider Active NPI

Brandon Holbert, RVT

  • Sonography Radiologic Technologist
  • Irving, TX
National Provider Identifier
1275922445
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
Practice address
310 San Mateo CT
Irving, TX 75062-4509
Phone
(817) 805-4001
NPI assigned
Jan 12, 2015
Last updated
Jan 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Radiologic Technologist 2471S1302X Primary

Addresses

Primary practice location

310 San Mateo CT
Irving, TX 75062-4509

Mailing address

310 San Mateo CT
Irving, TX 75062-4509
Phone (817) 805-4001

Other identifiers 1

IdentifierTypeStateIssuer
153257OtherTXLICENSE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Star Mobile Imaging Sonography Past Accepting new patients

Organizations & group practices 2

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": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1275922445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SAN MATEO CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624509",
            "telephone_number": "817-805-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SAN MATEO CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624509",
            "telephone_number": "817-805-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBERT",
        "first_name": "BRANDON",
        "credential": "RVT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "153257",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.