Brian Bumphus, PRSS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

41704171 Issued in TX

Practice address

26229 N Cranes Mill Rd
Canyon Lake, TX 78133-1957

Phone

(930) 935-2800

NPI assigned

Apr 15, 2021

Last updated

Apr 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wwos LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Antonio, TX
  • NPI 1598621591
  NPD
• Windmill Wellness Ranch LLC

  • Substance Abuse Rehabilitation Facility
  • Canyon Lake, TX
  • NPI 1063943041
  NPD (past)

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1790366300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 AUSTIN HWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094337",
            "telephone_number": "210-753-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26229 N CRANES MILL RD",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781331957",
            "telephone_number": "930-935-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMPHUS",
        "first_name": "BRIAN",
        "credential": "PRSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "41704171",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "41704171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bexarcare Pediatric Home Healthcare
• Blue Water Therapists, PLLC
• Brian Bodkin
• Brandon Grimm D.C. P.a. (Canyon Chiropractic)
• Brookshire Brothers Inc (Brookshire Brothers Pharmacy #79)
• Shawn Burch, LPC
• Eva Callahan
• Danny Lopez Campos, APRN, MSN, FNP-C
• Tammy Cantu, LPC
• Canyon Lake Dental PLLC

• Case Manager/Care Coordinator in Canyon Lake, TX
• Providers in Canyon Lake, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.