Individual provider Active NPI

Brian Charles Betz

  • Physical Therapy Assistant
  • Memphis, TN
National Provider Identifier
1033726898
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
6115 Issued in TN
Practice address
3965 S Mendenhall Rd Ste 20
Memphis, TN 38115-5954
Phone
(901) 620-3900
NPI assigned
Sep 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 6115 TN Primary

Addresses

Primary practice location

3965 S Mendenhall Rd Ste 20
Memphis, TN 38115-5954

Mailing address

3965 S Mendenhall Rd Ste 20
Memphis, TN 38115-5954

Other practice location 1

2781 Airways Blvd
Memphis, TN 38132-1104
Phone (901) 291-1100

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
6115TNMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1033726898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 S MENDENHALL RD STE 20",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381155954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 S MENDENHALL RD STE 20",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381155954",
            "telephone_number": "901-620-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2781 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381321104",
            "country_code": "US",
            "telephone_number": "901-291-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETZ",
        "first_name": "BRIAN",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "6115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.