NPIMap

Organization Active NPI

Beatty Harris Sports Medicine, LLC

  • Sports Medicine (Family Medicine) Physician
  • Newtown Square, PA
National Provider Identifier
1083239982
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
BEATTY HARRIS SPORTS MEDICINE, LLC
Practice address
3537 W Chester Pike
Newtown Square, PA 19073-3701
Phone
(610) 601-9177
Fax
(610) 723-7772
NPI assigned
Jun 16, 2020
Last updated
Jul 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Tricia Beatty, DONPI 1841275203
Title
Provider/Authorized Representative
Phone
(757) 617-5181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X NU Primary

Addresses

Primary practice location

3537 W Chester Pike
Newtown Square, PA 19073-3701

Mailing address

144 N. Narberth Avenue
P.O. Box 305
Narberth, PA 19072
Phone (610) 601-9177

Other practice location 1

2005 Marlton Pike E
Cherry Hill, NJ 08003-1279
Phone (610) 601-9177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200826000400 PA Part B Supplier - Clinic/Group Practice 2860819638 Receives reassigned benefits from 6 practitioners
Practice locations: Newtown Square, PA

National Provider Directory

National Provider Directory

Locations

144 N Narberth Ave
Unit 305
Narberth, PA 19072

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIFBCD

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1083239982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 N. NARBERTH AVENUE",
            "address_2": "P.O. BOX 305",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "19072",
            "telephone_number": "610-601-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 W CHESTER PIKE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733701",
            "telephone_number": "610-601-9177",
            "fax_number": "610-723-7772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 Marlton Pike E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080031279",
            "country_code": "US",
            "telephone_number": "610-601-9177",
            "fax_number": "610-723-7772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEATTY HARRIS SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "BEATTY",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PROVIDER/AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "757-617-5181",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.