NPIMap

Individual provider Active NPI

Brandon Beacom, DPT

  • Physical Therapist
  • Milton, WV
National Provider Identifier
1104174614
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT003042 Issued in WV
Practice address
1509 W Main St
Suite 201
Milton, WV 25541-1105
Phone
(304) 733-9560
Fax
(304) 733-1141
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003042 WV Primary

Addresses

Primary practice location

1509 W Main St
Suite 201
Milton, WV 25541-1105

Mailing address

1509 W Main St
Suite 201
Milton, WV 25541-1105
Phone (304) 733-9560

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT003042WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Generations R.C., Inc. Physical Therapist Past Accepting new patients
Generations R.C., Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1104174614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 W MAIN ST",
            "address_2": "SUITE 201",
            "city": "MILTON",
            "state": "WV",
            "postal_code": "255411105",
            "telephone_number": "304-733-9560",
            "fax_number": "304-733-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 W MAIN ST",
            "address_2": "SUITE 201",
            "city": "MILTON",
            "state": "WV",
            "postal_code": "255411105",
            "telephone_number": "304-733-9560",
            "fax_number": "304-733-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACOM",
        "first_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT003042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.