NPIMap

Organization Active NPI

Beebe Physical Therapy PLLC

  • Physical Therapist
  • Beebe, AR
National Provider Identifier
1437413622
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2923 Issued in AR
Legal business name
BEEBE PHYSICAL THERAPY PLLC
Practice address
710 W Dewitt Henry Dr Ste D
Beebe, AR 72012-2102
Phone
(501) 882-2260
NPI assigned
Jul 2, 2012
Last updated
Jul 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Jacob A Landrum, DPTNPI 1235239724
Title
PT/Owner
Phone
(501) 882-2260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2923 AR Primary

Addresses

Primary practice location

710 W Dewitt Henry Dr Ste D
Beebe, AR 72012-2102

Mailing address

PO Box 297
Beebe, AR 72012-0297
Phone (501) 882-2260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120904000231 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6002063633 Receives reassigned benefits from 5 practitioners
Practice locations: Beebe, AR

National Provider Directory

National Provider Directory

Locations

710 W Dewitt Henry Dr
Ste D
Beebe, AR 72012
Phone (501) 882-2260

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1437413622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "BEEBE",
            "state": "AR",
            "postal_code": "720120297",
            "telephone_number": "501-882-2260",
            "fax_number": "501-882-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W DEWITT HENRY DR STE D",
            "city": "BEEBE",
            "state": "AR",
            "postal_code": "720122102",
            "telephone_number": "501-882-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEEBE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "LANDRUM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "501-882-2260",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beebe, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.