Active NPI
Gretchen Kay Bedeaux, PT
- Physical Therapist
- Albuquerque, NM
National Provider Identifier
1457458101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 539
- Practice address
- 6020 Constitution Ave NE
Suite 4
Albuquerque, NM 87110-5900 - Phone
- (505) 255-5099
- NPI assigned
- Sep 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 539 | NM | Primary |
Addresses
Primary practice location
6020 Constitution Ave NE
Suite 4
Albuquerque, NM 87110-5900
Mailing address
6020 Constitution Ave NE
Suite 4
Albuquerque, NM 87110-5900
Phone (505) 255-5099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00071594 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 539 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1457458101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6020 CONSTITUTION AVE NE",
"address_2": "SUITE 4",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871105900",
"telephone_number": "505-255-5099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6020 CONSTITUTION AVE NE",
"address_2": "SUITE 4",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871105900",
"telephone_number": "505-255-5099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDEAUX",
"first_name": "GRETCHEN",
"middle_name": "KAY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "539",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00071594",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.