Active NPI
Beth Amy Nordstrom, PT
- Physical Therapist
- Red Lodge, MT
National Provider Identifier
1609936095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 478
- Practice address
- 600 W 21St St.
Red Lodge, MT 59068 - Phone
- (406) 446-1112
- Fax
- (406) 446-0082
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 478 | MT | Primary |
Addresses
Primary practice location
600 W 21St St.
Red Lodge, MT 59068
Mailing address
PO Box 590
Red Lodge, MT 59068-0590
Phone (406) 446-1112
Other names 1
- Beth Amy Jinks
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
| License | State | Type | Specialty |
|---|---|---|---|
| 478 | MT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609936095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 590",
"city": "RED LODGE",
"state": "MT",
"postal_code": "590680590",
"telephone_number": "406-446-1112",
"fax_number": "406-446-0082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 W 21ST ST.",
"city": "RED LODGE",
"state": "MT",
"postal_code": "59068",
"telephone_number": "406-446-1112",
"fax_number": "406-446-0082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDSTROM",
"first_name": "BETH",
"middle_name": "AMY",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MT",
"license": "478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BETH",
"last_name": "JINKS",
"middle_name": "AMY",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Red Lodge, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.