Individual provider Active NPI

Justin Beichler, PTA

  • Physical Therapy Assistant
  • Ellicott City, MD
National Provider Identifier
1225548043
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A4611 Issued in MD
Practice address
6011 University Blvd Ste 120
Ellicott City, MD 21043-6104
Phone
(410) 203-0391
Fax
(410) 203-2707
NPI assigned
Oct 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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 A4611 MD Primary

Addresses

Primary practice location

6011 University Blvd Ste 120
Ellicott City, MD 21043-6104

Mailing address

6011 University Blvd Ste 120
Ellicott City, MD 21043-6104
Phone (410) 203-0391

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
A4611MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1225548043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 UNIVERSITY BLVD STE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436104",
            "telephone_number": "410-203-0391",
            "fax_number": "410-203-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 UNIVERSITY BLVD STE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436104",
            "telephone_number": "410-203-0391",
            "fax_number": "410-203-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEICHLER",
        "first_name": "JUSTIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.