Individual provider Active NPI

Thomas R Beckman Jr., LPN

  • Licensed Practical Nurse
  • Des Moines, WA
National Provider Identifier
1609721372
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
095625 Issued in GA
Practice address
20817 17TH Ave S
Des Moines, WA 98198-7665
Phone
(206) 257-6275
NPI assigned
Feb 27, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 095625 GA Primary

Addresses

Primary practice location

20817 17TH Ave S
Des Moines, WA 98198-7665

Mailing address

20817 17TH Ave S
Des Moines, WA 98198-7665

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
095625GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1609721372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20817 17TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20817 17TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987665",
            "telephone_number": "206-257-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKMAN",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "095625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.