Individual provider Active NPI

Brendon Ehrlich, PT, DPT, LAT, ATC

  • Physical Therapist
  • Bismarck, ND
National Provider Identifier
1831649581
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2311 Issued in ND
Practice address
1800 E Interstate Ave
Bismarck, ND 58503-1399
Phone
(017) 323-8943
NPI assigned
Oct 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 755-17 ND
Physical Therapist 225100000X 2311 ND Primary

Addresses

Primary practice location

1800 E Interstate Ave
Bismarck, ND 58503-1399

Mailing address

217 W Burleigh Ave Apt 214
Bismarck, ND 58504-9049

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2311NDMDPhysical Therapist
755-17NDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1831649581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W BURLEIGH AVE APT 214",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585049049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E INTERSTATE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031399",
            "telephone_number": "017-323-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "BRENDON",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ND",
            "license": "755-17",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.