Individual provider Active NPI

Jessica Beavers

  • Physical Therapist
  • Fuquay Varina, NC
National Provider Identifier
1659067981
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
400 Attain St Ste 102
Fuquay Varina, NC 27526-2702
Phone
(919) 754-4111
Fax
(919) 521-5223
NPI assigned
Apr 11, 2023
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

400 Attain St Ste 102
Fuquay Varina, NC 27526-2702

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 558-0076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230426001470 NC Practitioner - Physical Therapist in Private Practice 3476918459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

1901 Nwcary Pkwy
Suite 110
Morrisville, NC 27560
Phone (919) 678-1525

400 Attain St
Suite 102
Fuquay Varina, NC 27526-2702
Phone (919) 754-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Mar 13, 2023 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Mar 13, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

688 Cary Towne Blvd
Cary, NC 27511
Phone (919) 324-6344

400 Attain St
Ste 102
Fuquay Varina, NC 27526
Phone (919) 754-4111

1901 NW Cary Pkwy
Ste 110
Morrisville, NC 27560
Phone (919) 678-1525

Organizations & group practices 2

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": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1659067981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-558-0076",
            "fax_number": "423-558-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ATTAIN ST STE 102",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262702",
            "telephone_number": "919-754-4111",
            "fax_number": "919-521-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.