Individual provider Active NPI

Eric Dale Brummel, PT

  • Physical Therapist
  • Prescott, AZ
National Provider Identifier
1801814066
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3833 Issued in AZ
Practice address
115 E Goodwin St
Suite E1
Prescott, AZ 86303-3926
Phone
(928) 445-5639
Fax
(928) 442-0031
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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 3833 AZ Primary

Addresses

Primary practice location

115 E Goodwin St
Suite E1
Prescott, AZ 86303-3926

Mailing address

PO Box 13159
Prescott, AZ 86304-3159
Phone (928) 445-5639

Other identifiers 2

IdentifierTypeStateIssuer
554239MedicaidAZ
AZ0463420OtherAZBCBS

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

State licenses

LicenseStateTypeSpecialty
3833AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Garcia Physical Therapy, LLC PastSince Jan 29, 2016 Accepting new patients
Switzer Medical Inc PastSince Dec 1, 2002 Accepting new patients
Svassama PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 3

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1801814066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13159",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863043159",
            "telephone_number": "928-445-5639",
            "fax_number": "928-442-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E GOODWIN ST",
            "address_2": "SUITE E1",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863033926",
            "telephone_number": "928-445-5639",
            "fax_number": "928-442-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMEL",
        "first_name": "ERIC",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "3833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "554239",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0463420",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.