Individual provider Active NPI

Bethany Lawson, PTA

  • Physical Therapy Assistant
  • Mountain Grove, MO
National Provider Identifier
1205654720
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2019027359 Issued in MO
Practice address
1206 N Main St
Mountain Grove, MO 65711-1025
Phone
(417) 926-5699
Fax
(417) 926-5703
NPI assigned
Oct 2, 2024
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 2019027359 MO Primary

Addresses

Primary practice location

1206 N Main St
Mountain Grove, MO 65711-1025

Mailing address

833 Turnbo Rd
Marshfield, MO 65706-9070
Phone (417) 241-0185

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
2019027359MOMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialist Clinic, Inc. Physical Therapy Assistant CurrentSince Oct 6, 2024 Accepting new patients

Locations

1206 N Main St
Mountain Grv, MO 65711
Phone (417) 926-5699

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1205654720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 TURNBO RD",
            "city": "MARSHFIELD",
            "state": "MO",
            "postal_code": "657069070",
            "telephone_number": "417-241-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111025",
            "telephone_number": "417-926-5699",
            "fax_number": "417-926-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "BETHANY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2019027359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.