Individual provider Active NPI

Joseph P Beckham, DPT

  • Physical Therapist
  • Tallahassee, FL
National Provider Identifier
1114915642
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20953 Issued in FL
Practice address
1618 Mahan Center Blvd
Suite 104
Tallahassee, FL 32308-5477
Phone
(850) 325-6307
Fax
(850) 325-6387
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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 PT20953 FL Primary

Addresses

Primary practice location

1618 Mahan Center Blvd
Suite 104
Tallahassee, FL 32308-5477

Mailing address

1305 Leewood Dr
Tallahassee, FL 32312-2506
Phone (850) 553-7273

Other identifiers 3

IdentifierTypeStateIssuer
262475406OtherFLTAX IDENTIFIER
Y123SOtherFLBCBS PROVIDER ID
U5183ZOtherFLMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050806000071 FL Practitioner - Physical Therapist in Private Practice 1759310113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopedic and Sports Physical Therapy P aGroup PAC ID 7810069127, 24 clinicians

Practice addresses (Care Compare)

2615 Centennial Blvd
Suite 101
Tallahasse, FL 32308-0589
Phone (850) 656-1837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic and Sports Physical Therapy P a Physical Therapist CurrentSince Jan 20, 2020 Accepting new patients
Chipley Physical Therapy, Inc Physical Therapist Past Accepting new patients
Physical Therapy Associates of Orange Park, Inc Physical Therapist PastSince Feb 1, 2000 Accepting new patients
Bonifay Physical Therapy Physical Therapist Past Accepting new patients

Locations

2615 Centennial Blvd
Ste 101
Tallahassee, FL 32308

Organizations & group practices 4

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1114915642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 LEEWOOD DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323122506",
            "telephone_number": "850-553-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 MAHAN CENTER BLVD",
            "address_2": "SUITE 104",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085477",
            "telephone_number": "850-325-6307",
            "fax_number": "850-325-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKHAM",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFIER",
            "identifier": "262475406",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "Y123S",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "U5183Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.