Gregory Beacham II

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

M04919 Issued in MD

Practice address

7700 Old Branch Ave
Clinton, MD 20735-1628

Phone

(202) 649-0506

NPI assigned

Jan 19, 2016

Last updated

Jan 19, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1164889390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 SONAR RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352962",
            "telephone_number": "202-649-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351628",
            "telephone_number": "202-649-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACHAM",
        "first_name": "GREGORY",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "M04919",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "DC",
            "license": "MT1474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Barnes
• Nekia Oriana Barrow, MD, MPH
• Rosemond Bartels, NP
• Rita A. Bass, M.D.
• Yata Haja Bazzie, FNP
• Beautiful Smiles, L.L.C.
• Heather Lynn Beck, PA-C
• Naliah Beckford
• Yazmin Beeks, LGSW
• Steven Belcher

• Massage Therapist in Clinton, MD
• Providers in Clinton, MD by specialty
• Massage Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.