Bethany Leeann Imus

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1550 NE Williamson Blvd Ste 120
Bend, OR 97701-6091

Phone

(541) 640-5601

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1245858851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 NE 4TH ST APT 5",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014358",
            "telephone_number": "503-407-8976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NE WILLIAMSON BLVD STE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016091",
            "telephone_number": "541-640-5601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 NE Williamson Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016091",
            "country_code": "US",
            "telephone_number": "541-640-5601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMUS",
        "first_name": "BETHANY",
        "middle_name": "LEEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Savanah J Imus
• In Balance Physical Therapy, LLC
• Infocus Eye Care LLC (Infocus Eye Care Center)
• Kathy M Ingelse, PMHNP, FNP
• David G Ingraham, MD

• Behavior Technician in Bend, OR
• Providers in Bend, OR by specialty
• Behavior Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.