Bryan Davis Beasley, ATC/L

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

AT002017 Issued in GA

Practice address

2659 Abutment Rd
Dalton, GA 30721-4887

Phone

(706) 532-6700

NPI assigned

Apr 29, 2010

Last updated

Dec 17, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Premise Health of Georgia Medical PC

  dba Shaw Family Health Center

  • Multi-Specialty Clinic/Center
  • Dalton, GA
  • NPI 1588128656
  NPD (past)

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1548587694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 GOVERNORS CT",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301214272",
            "telephone_number": "615-604-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 ABUTMENT RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307214887",
            "telephone_number": "706-532-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "BRYAN",
        "middle_name": "DAVIS",
        "credential": "ATC/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-29",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "GA",
            "license": "AT002017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Carson Baskin, PTA
• Kimberly Lynn Bates, LDO
• W. Jeffrey Battles, D.M.D.
• Paula Shurden Batts, LMFT
• Stacy Bean, OTR/L, CBIS
• Mary Beavers, LPC
• Melissa Darlene Beavers, LMSW
• Greta W Beckler, PT
• Natalie Anne Bedwell, COTA
• Richard M Belle Isle, M.D.

• Rehabilitation Practitioner in Dalton, GA
• Providers in Dalton, GA by specialty
• Rehabilitation Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.