NPIMap

Individual provider Active NPI

Brent Eenigenburg, ATP

  • Other Technician
  • Sherman, TX
National Provider Identifier
1407254964
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
8015 S US Highway 75
Sherman, TX 75090-5707
Phone
(903) 532-5656
Fax
(903) 532-5665
NPI assigned
Dec 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X ATP 7744 TX
Assistive Technology Practitioner Rehabilitation Counselor 225CA2400X ATP 7744 TX
Assistive Technology Supplier Rehabilitation Counselor 225CA2500X ATP 7744 TX
Orientation and Mobility Training Rehabilitation Counselor 225CX0006X ATP 7744 TX
Other Technician 247200000X Primary

Addresses

Primary practice location

8015 S US Highway 75
Sherman, TX 75090-5707

Mailing address

8015 S US Highway 75
Sherman, TX 75090-5707
Phone (903) 532-5656

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

State licenses

LicenseStateTypeSpecialty
ATP 7744TXMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Seating and Mobility LLC Past Accepting new patients
Aoc-DME Corp. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1407254964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 S US HIGHWAY 75",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750905707",
            "telephone_number": "903-532-5656",
            "fax_number": "903-532-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 S US HIGHWAY 75",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750905707",
            "telephone_number": "903-532-5656",
            "fax_number": "903-532-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EENIGENBURG",
        "first_name": "BRENT",
        "credential": "ATP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-16",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "TX",
            "license": "ATP 7744",
            "primary": false
        },
        {
            "code": "225CA2400X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Practitioner",
            "state": "TX",
            "license": "ATP 7744",
            "primary": false
        },
        {
            "code": "225CA2500X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Supplier",
            "state": "TX",
            "license": "ATP 7744",
            "primary": false
        },
        {
            "code": "225CX0006X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
            "state": "TX",
            "license": "ATP 7744",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.