Individual provider Active NPI

Brent Sherwood, M.D.

  • Family Medicine Physician
  • Colorado City, TX
National Provider Identifier
1366540197
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L8191 Issued in TX
Practice address
997 W Interstate 20
Colorado City, TX 79512-2685
Phone
(325) 728-2693
Fax
(325) 728-2420
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L8191 TX Primary

Addresses

Primary practice location

997 W Interstate 20
Colorado City, TX 79512-2685

Mailing address

997 W Interstate 20
Colorado City, TX 79512-2685
Phone (325) 728-2693

Other identifiers 2

IdentifierTypeStateIssuer
167345104MedicaidTX
8W2460OtherTXBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000316 TX Practitioner - Family PracticePractitioner - Emergency Medicine 6507838034 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Aug 21, 2020 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Aug 21, 2020 Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Emergency Physicians of North Texas PLLC Past Accepting new patients
Texas Tech University Health Sciences Center University Associates Family Medicine Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Umc Physicians Family Medicine Past Accepting new patients
Panhandle Emergency Physicians, P.a. Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

1 Avenue N
Haskell, TX 79521
Phone (940) 228-4321

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

540 W 15th St
Hereford, TX 79045
Phone (806) 364-2141

Interoperability endpoints

  • Direct secure messaging: bwsherwood@directaddress.net

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1366540197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 W INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-2693",
            "fax_number": "325-728-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 W INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-2693",
            "fax_number": "325-728-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "BRENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167345104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8W2460",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado City, TX

Sources for this page

Verify at the official NPI Registry.