Individual provider Active NPI

Beverly L Eckhardt, PTA, CLT

  • Physical Therapy Assistant
  • Los Alamitos, CA
National Provider Identifier
1174656326
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT1354 Issued in CA
Practice address
5122 Katella Ave # 16
Los Alamitos, CA 90720-2826
Phone
(562) 795-5295
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT1354 CA Primary

Addresses

Primary practice location

5122 Katella Ave # 16
Los Alamitos, CA 90720-2826

Mailing address

10435 Molette St
Bellflower, CA 90706-4130
Phone (562) 804-0251

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT1354CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alamitos Physical Therapy Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174656326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10435 MOLETTE ST",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907064130",
            "telephone_number": "562-804-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE # 16",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202826",
            "telephone_number": "562-795-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHARDT",
        "first_name": "BEVERLY",
        "middle_name": "L",
        "credential": "PTA, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT1354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.