Individual provider Active NPI

Brent Henry Cordery, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1669597555
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2429 Issued in NE
Practice address
625 N 144TH St Suite #1
Omaha, NE 68154
Phone
(402) 350-1131
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2429 NE Primary

Addresses

Primary practice location

625 N 144TH St Suite #1
Omaha, NE 68154

Mailing address

260 S 199TH St
Elkhorn, NE 68022-4865
Phone (402) 350-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000507 NE Practitioner - Physical Therapist in Private Practice 9335155589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omaha Physical Therapy Institute, PCGroup PAC ID 3072613421, 8 clinicians

Practice addresses (Care Compare)

625 N 144TH Ave
Suite 102
Omaha, NE 68154-1935
Phone (402) 934-8688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2429NEMDOccupational Therapist
7079MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Physical Therapy Institute, PC Physical Therapist CurrentSince Jun 28, 2007 Accepting new patients

Locations

625 N 144th Ave
Ste 102
Omaha, NE 68154
Phone (402) 934-8688

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669597555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S 199TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224865",
            "telephone_number": "402-350-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N 144TH ST SUITE #1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-350-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERY",
        "first_name": "BRENT",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.