Individual provider Active NPI

Denise D Beitel, L.M.T.

  • Specialist
  • Ormond Beach, FL
National Provider Identifier
1235347766
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA19045 Issued in FL
Practice address
170 S Yonge St
Ste. a
Ormond Beach, FL 32174-6286
Phone
(386) 673-0524
Fax
(386) 673-0539
NPI assigned
May 18, 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
Specialist 174400000X MA19045 FL Primary

Addresses

Primary practice location

170 S Yonge St
Ste. a
Ormond Beach, FL 32174-6286

Mailing address

460 Sauls St
Ormond Beach, FL 32174-7561
Phone (386) 672-1001

Other identifiers 1

IdentifierTypeStateIssuer
C4024OtherFLBLUE CROSS BLUE SHIELD OF

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
MA19045FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235347766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 SAULS ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747561",
            "telephone_number": "386-672-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 S YONGE ST",
            "address_2": "STE. A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746286",
            "telephone_number": "386-673-0524",
            "fax_number": "386-673-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEITEL",
        "first_name": "DENISE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA19045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "C4024",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

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.