Active NPI
Brenford Edwin Sergent, OTR/L
- Occupational Therapist
- Martinsburg, WV
National Provider Identifier
1720607013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1080
- Practice address
- 653 Street of Dreams
Martinsburg, WV 25403-1140 - Phone
- (304) 582-4977
- NPI assigned
- Apr 16, 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1080 | WV | Primary |
Addresses
Primary practice location
653 Street of Dreams
Martinsburg, WV 25403-1140
Mailing address
653 Street of Dreams
Martinsburg, WV 25403-1140
Phone (304) 582-4977
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": "1586995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1720607013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "653 STREET OF DREAMS",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254031140",
"telephone_number": "304-582-4977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 STREET OF DREAMS",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254031140",
"telephone_number": "304-582-4977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERGENT",
"first_name": "BRENFORD",
"middle_name": "EDWIN",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-16",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WV",
"license": "1080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.