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Brentley Kyle Blackmon, PTA

Physical Therapy Assistant in Waco, TX · enumerated 2018.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1114409588

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Registry record

Entity type Individual (Type 1)
Name Brentley Kyle Blackmon
Credential PTA
Sex Male
Practice address 401 Owen Ln, Waco, TX, 76710
Phone (254) 772-8900
Enumeration date Sep 3, 2018
Last updated in NPPES Sep 3, 2018

Taxonomy & licenses

225200000X Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 2108097 (TX) Primary

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Brentley Blackmon?
The National Provider Identifier (NPI) for Brentley Blackmon is 1114409588, a Type 1 (individual) record in the CMS NPPES registry.
Where does Brentley Blackmon practice?
The practice location on file with NPPES is in Waco, TX. Providers can have multiple locations; NPPES lists the primary practice address.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-09-03.