Individual provider Active NPI

Benjamin Macon Renfrow, MSPT

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1417043944
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1150587 Issued in TX
Practice address
1730 Lamonte Lane
Houston, TX 77018
Phone
(713) 628-1780
Fax
(713) 838-2238
NPI assigned
Oct 4, 2006
Last updated
Dec 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 1150587 TX Primary

Addresses

Primary practice location

1730 Lamonte Lane
Houston, TX 77018

Mailing address

1730 Lamonte Lane
Houston, TX 77018
Phone (713) 628-1780

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

State licenses

LicenseStateTypeSpecialty
1150587TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovations in Physical Therapy, Inc. Physical Therapist PastSince Aug 30, 2011 Accepting new patients
Hope Rehab LTD Physical Therapist PastSince Aug 1, 2016 Accepting new patients
Buckeye 96 LP Physical Therapist PastSince Oct 10, 2014 Accepting new patients

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1417043944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 LAMONTE LANE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77018",
            "telephone_number": "713-628-1780",
            "fax_number": "713-838-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 LAMONTE LANE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77018",
            "telephone_number": "713-628-1780",
            "fax_number": "713-838-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFROW",
        "first_name": "BENJAMIN",
        "middle_name": "MACON",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1150587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.