Active NPI
Michael Clelland Brents, PT, DPT
- Physical Therapist
- Campbellsville, KY
National Provider Identifier
1508471145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 005671
- Practice address
- 190 W 1St St Ste 103
Campbellsville, KY 42718-2264 - Phone
- (270) 789-6629
- NPI assigned
- Sep 10, 2020
- Last updated
- Sep 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 005671 | KY | Primary |
Addresses
Primary practice location
190 W 1St St Ste 103
Campbellsville, KY 42718-2264
Mailing address
7202 Williamsgate Blvd
Crestwood, KY 40014-7017
Phone (502) 689-6557
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005671 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1508471145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7202 WILLIAMSGATE BLVD",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "400147017",
"telephone_number": "502-689-6557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 W 1ST ST STE 103",
"city": "CAMPBELLSVILLE",
"state": "KY",
"postal_code": "427182264",
"telephone_number": "270-789-6629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENTS",
"first_name": "MICHAEL",
"middle_name": "CLELLAND",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "005671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbellsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.