Jeffrey A Beyer, PT

Key facts

NPI

1124155692

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

2551 (MN)

Practice address

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522

Phone

(763) 236-8911

Fax

(763) 236-8990

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124155692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10124 RAVEN ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334647",
            "telephone_number": "763-236-9811",
            "fax_number": "763-236-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-8911",
            "fax_number": "763-236-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYER",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Coon Rapids, MN · Physical Therapist in Minnesota