Individual provider Active NPI

Beau Caviness, PT

  • Physical Therapist
  • Gardendale, AL
National Provider Identifier
1619733649
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
550 Fieldstown Rd
Gardendale, AL 35071-2590
Phone
(205) 418-1482
Fax
(205) 608-5179
NPI assigned
Feb 27, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X PTH11733 AL
Physical Therapist 225100000X AL Primary

Addresses

Primary practice location

550 Fieldstown Rd
Gardendale, AL 35071-2590

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

833 Saint Vincents Dr Ste 100
Birmingham, AL 35205-1609
Phone (205) 730-3190

Other practice location 2

550 Fieldstown Rd
Gardendale, AL 35071-2590
Phone (205) 418-1482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412000558 AL Practitioner - Physical Therapist in Private Practice 2264871045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Alabama LLCGroup PAC ID 2769756436, 66 clinicians

Practice addresses (Care Compare)

550 Fieldstown Rd
Gardendale, AL 35071-2590
Phone (205) 418-1482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH11733ALMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Alabama, LLC Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients

Locations

634 1st St N
Ste 100
Alabaster, AL 35007
Phone (205) 728-2535

833 Saint Vincents Dr
Ste 100
Birmingham, AL 35205
Phone (205) 730-3190

9256 Parkway E
Ste A
Birmingham, AL 35206
Phone (205) 855-2003

1877 Cherokee Ave SW
Cullman, AL 35055
Phone (256) 727-1701

323 Fieldstown Rd
Ste 105
Gardendale, AL 35071
Phone (205) 607-3217

550 Fieldstown Rd
Gardendale, AL 35071
Phone (205) 418-1482

1401 Doug Baker Blvd
Ste 104
Hoover, AL 35242
Phone (205) 730-3660

2804 John Hawkins Pkwy
Ste 104
Hoover, AL 35244
Phone (205) 201-7747

3650 Bethune Dr
Mountain Brk, AL 35223
Phone (205) 243-8950

106 6th St S
Ste A
Oneonta, AL 35121
Phone (205) 460-3817

301 Huntley Pkwy
Pelham, AL 35124
Phone (205) 564-9117

3143 Pelham Pkwy
Ste 400
Pelham, AL 35124
Phone (205) 664-3197

3735 Corporate Woods Dr
Ste 109
Vestavia, AL 35242
Phone (205) 201-7358

636 Montgomery Hwy
Vestavia Hills, AL 35216
Phone (205) 533-7066

790 Remington Blvd
Bolingbrook, IL 60440

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1619733649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FIELDSTOWN RD",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712590",
            "telephone_number": "205-418-1482",
            "fax_number": "205-608-5179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Saint Vincents Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352051609",
            "country_code": "US",
            "telephone_number": "205-730-3190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Fieldstown Rd",
            "address_purpose": "LOCATION",
            "city": "Gardendale",
            "state": "AL",
            "postal_code": "350712590",
            "country_code": "US",
            "telephone_number": "205-418-1482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVINESS",
        "first_name": "BEAU",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AL",
            "license": "PTH11733",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.