Active NPI
Janice Beller, PT
- Physical Therapist
- Belleville, IL
National Provider Identifier
1194873364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 106 Lincoln Place CT
Belleville, IL 62221-5884 - Phone
- (618) 236-7588
- NPI assigned
- Jan 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
106 Lincoln Place CT
Belleville, IL 62221-5884
Mailing address
106 Lincoln Place CT
Belleville, IL 62221-5884
Phone (618) 236-7588
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001415008 | Other | IL | BCBS OF IL |
| 5330619 | Other | AETNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070-001612 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brefeld Physical Therapy Services PC | Physical Therapist | 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.
-
- Physical Therapist
- Belleville, IL
- NPI 1053308015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1194873364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LINCOLN PLACE CT",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622215884",
"telephone_number": "618-236-7588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LINCOLN PLACE CT",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622215884",
"telephone_number": "618-236-7588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLER",
"first_name": "JANICE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-06",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IL",
"identifier": "0001415008",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5330619",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
- Bel Clair Ambulatory Surgical Treatment Center, LTD
- Bel Clair Ambulatory Surgical Treatment Center, LTD.
- Neil Belanger, CRNA
- Stephen Bell, MD
- Belle Valley School District 119
- Belleville Area SPC SRV Co - Adm
- Belleville Area Special Services Cooperative
- Belleville Area Special Services Cooperative
- Belleville Behavioral Health & Nursing Center LLC
- Belleville Dental Care
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.