Shaun Matthew Bean, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4943 Issued in NV

Practice address

6823 Ponderosa Way
Las Vegas, NV 89118-2100

Phone

(702) 665-4054

NPI assigned

Aug 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prism PT LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1992339824
  NPD

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

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659830400000",
    "number": "1497482699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6541 ZA ZU PITTS AVE UNIT 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891221704",
            "telephone_number": "702-917-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6823 PONDEROSA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182100",
            "telephone_number": "702-665-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "SHAUN",
        "middle_name": "MATTHEW",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-07",
        "last_updated": "2022-08-07",
        "certification_date": "2022-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE NUMBER",
            "identifier": "4943",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soren Beal, DO
• Peter Duncan Beale, M.D.
• David Beals
• Molly Beam
• Rhett K Beaman, D.C.
• Tyler Bean, DO
• Charla D Bear
• Jessica Bear, M.D.
• Kennedi Beard-Williams
• Caffie Beard

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2022; 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.