Beau Dobson, PT, DPT, OCS, CSCS

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT-4218 Issued in ID

Practice address

109 13TH Ave S
Nampa, ID 83651-3904

Phone

(209) 995-6671

NPI assigned

Jun 16, 2015

Last updated

Apr 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Beyond Physical Therapy & Performance PLLC

  dba Beyond Physical Therapy & Performance

  • Orthopedic Physical Therapist
  • Nampa, ID
  • NPI 1336721802
  NPD Authorized official

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1245611276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17415 N FLAGSTAFF WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875495",
            "telephone_number": "608-558-3657",
            "fax_number": "208-473-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 13TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513904",
            "telephone_number": "209-995-6671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Constitution Way",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "83686",
            "country_code": "US",
            "telephone_number": "208-463-5570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOBSON",
        "first_name": "BEAU",
        "credential": "PT, DPT, OCS, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": "PT-4218",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ID",
            "license": "PT-4218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Nicholas Dixon
• Marty Dixon
• Teresa Ann Dixon, RN
• Katylynn Ann Dizdarevic-Miller, MD
• Michael R. Djernes, M.D.
• Dena Dodge, L.P.C.
• Bailey Kathryn Dolan-Bopp
• Eric Donahue
• Donaldson Chiropractic, Inc.
• Martin Sterling Donaldson, D.C.

• Physical Therapy Clinic/Center in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Therapy Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.