Brian L Beaulieu, PT, MPT, OCS,CMTPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305202244 Issued in VA

Practice address

2004 Sandbridge Rd Ste 102
Virginia Beach, VA 23456-4084

Phone

(757) 301-6419

Fax

(757) 301-6419

NPI assigned

Apr 13, 2006

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1568426989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69030",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649030",
            "telephone_number": "757-873-2302",
            "fax_number": "757-873-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 SANDBRIDGE RD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564084",
            "telephone_number": "757-301-6419",
            "fax_number": "757-301-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "BRIAN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PT, MPT, OCS,CMTPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00140444",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010097215",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PHYSICAL THERAPY",
            "identifier": "192967",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7445089",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan C Beasley
• Barbara Terese Beatty, LPC, NCC, CSAC
• Maxine Ruth Beatty, MD
• Hailey Beaudry, PA-C, RDN
• Edith Caroly Beaujon, LSW
• Elizabeth Beaume-Vinasco
• Beautiful and Joyful Ventures Inc
• Beaver Sloan Christian and Mental Health Counseling
• Margaret Beaver, CPNP-PC, MSN, RN
• Robert Charles Beba, PT

• Physical Therapist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.