Individual provider Active NPI

Brent Herndon

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1619323300
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S2794 Issued in TX
Practice address
13376 Research Blvd Ste 110
Austin, TX 78750-2257
Phone
(512) 324-8355
NPI assigned
May 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 10056854 TX
Internal Medicine Physician 207R00000X S2794 TX Primary

Addresses

Primary practice location

13376 Research Blvd Ste 110
Austin, TX 78750-2257

Mailing address

13376 Research Blvd Ste 110
Austin, TX 78750-2257
Phone (512) 324-8355

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
I20200804000563 TX Practitioner - Internal Medicine 9638594922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Networks, Inc.Group PAC ID 6002091261, 116 clinicians

Practice addresses (Care Compare)

4330 Medical Dr
Suite 500
San Antonio, TX 78229-3318
Phone (210) 558-0122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10056854TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Networks, Inc. CurrentSince Apr 30, 2020 Accepting new patients

Locations

13376 Research Blvd
Ste 110
Austin, TX 78750
Phone (512) 219-0129

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: brent.herndon@wellmed.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1619323300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13376 RESEARCH BLVD STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502257",
            "telephone_number": "512-324-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13376 RESEARCH BLVD STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502257",
            "telephone_number": "512-324-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "10056854",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S2794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.