Individual provider Active NPI

Elmer Henry Benhardt, LPT

  • Physical Therapist
  • Conroe, TX
National Provider Identifier
1518904341
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1001154 Issued in TX
Practice address
4015 Interstate 45 N
Conroe, TX 77304-4901
Phone
(936) 522-4731
Fax
(936) 522-4737
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1001154 TX Primary

Addresses

Primary practice location

4015 Interstate 45 N
Conroe, TX 77304-4901

Mailing address

4015 Interstate 45 N
Conroe, TX 77304-4901
Phone (936) 522-4731

Other identifiers 1

IdentifierTypeStateIssuer
183822901MedicaidTX

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

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1518904341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044901",
            "telephone_number": "936-522-4731",
            "fax_number": "936-522-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044901",
            "telephone_number": "936-522-4731",
            "fax_number": "936-522-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENHARDT",
        "first_name": "ELMER",
        "middle_name": "HENRY",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1001154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183822901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.