1164511069 NPI number — MICHELLE BEAMER DPT

Table of content: MICHELLE BEAMER DPT (NPI 1164511069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164511069 NPI number — MICHELLE BEAMER DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEAMER
Provider First Name:
MICHELLE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164511069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6142 POPES CREEK PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAYMARKET
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-230-2816
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
480 S COMMERCE AVE STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRONT ROYAL
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22630-3093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-636-3500
Provider Business Practice Location Address Fax Number:
540-636-3502
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305202439 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010034612 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 194082 . This is a "BCBS GROUP # FR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4576361 . This is a "GROUP #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 460032 . This is a "BCBS INDIVIDUAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 150718500 . This is a "DEPT OF LABOR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 277958 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 102811 . This is a "BCBS AQUATIC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541966445 . This is a "UHC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 16040 . This is a "COMMUNITY HEALTH GRP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 194085 . This is a "BCBS GROUP # WS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541966445 . This is a "FIRST HEALTH GROUP #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541966445 . This is a "SOUTHERN HEALTH GROUP#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 650024447 . This is a "RR MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 194083 . This is a "BCBS GROUP # WI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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