Stacie Ireen Beyer – Physical Therapy Assistant

Key facts

NPI: 1093096752
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: 001680 (WV)
Practice address: 772 Foxcroft Ave # 14
Martinsburg, WV 25401-1838
Phone: (304) 262-8161
Fax: (304) 262-6061
NPI assigned: Sep 7, 2011
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

King Physical Therapy, Inc. Physical Therapy Clinic/Center · Martinsburg, WV · NPI 1871764209

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
001680	WV	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
King Physical Therapy, Inc.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	001680	WV	Yes

Addresses

Primary practice location

772 Foxcroft Ave # 14
Martinsburg, WV 25401-1838

Mailing address

772 Foxcroft Ave # 14
Martinsburg, WV 25401-1838
Phone (304) 262-8161

Other identifiers

Identifier	Type	State	Issuer
9350561	Other	WV	MEDICARE P10

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 7, 2011.

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1093096752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 FOXCROFT AVE # 14",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254011838",
            "telephone_number": "304-262-8161",
            "fax_number": "304-262-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 FOXCROFT AVE # 14",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254011838",
            "telephone_number": "304-262-8161",
            "fax_number": "304-262-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYER",
        "first_name": "STACIE",
        "middle_name": "IREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "001680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P10",
            "identifier": "9350561",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

All providers in Martinsburg, WV · Physical Therapy Assistant in West Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.