Individual provider Active NPI

Beverly E Carnage

  • Physical Therapy Assistant
  • Quitman, GA
National Provider Identifier
1477025575
Registry record updated Dec 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
001730 Issued in GA
Practice address
301 E Screven St
Quitman, GA 31643-2131
Phone
(229) 263-6191
NPI assigned
Dec 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 001730 GA Primary

Addresses

Primary practice location

301 E Screven St
Quitman, GA 31643-2131

Mailing address

210 Chatham Dr
Thomasville, GA 31792-3709
Phone (229) 289-2519

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
001730GAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546128000000",
    "number": "1477025575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CHATHAM DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317923709",
            "telephone_number": "229-289-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SCREVEN ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316432131",
            "telephone_number": "229-263-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNAGE",
        "first_name": "BEVERLY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-30",
        "last_updated": "2018-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "001730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quitman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; 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.