Individual provider Active NPI

Brenda Jean Beller, PTA

  • Physical Therapy Assistant
  • Terre Haute, IN
National Provider Identifier
1497071880
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06002005A Issued in IN
Practice address
2 Rutledge Dr
Terre Haute, IN 47803-2020
Phone
(812) 877-6946
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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 06002005A IN Primary

Addresses

Primary practice location

2 Rutledge Dr
Terre Haute, IN 47803-2020

Mailing address

2 Rutledge Dr
Terre Haute, IN 47803-2020
Phone (812) 877-6946

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
06002005AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270944000000",
    "number": "1497071880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RUTLEDGE DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478032020",
            "telephone_number": "812-877-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RUTLEDGE DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478032020",
            "telephone_number": "812-877-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLER",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2010-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06002005A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2010; 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.