Bethany Siebelink, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5036 Issued in MD

Practice address

2075 NW Highland Ave
Grants Pass, OR 97526-3310

Phone

(541) 476-8891

NPI assigned

Jun 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1679922454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12605 BLACKFOOT TRL",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787297704",
            "telephone_number": "512-701-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 NW HIGHLAND AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975263310",
            "telephone_number": "541-476-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBELINK",
        "first_name": "BETHANY",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2021-09-08",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "09299",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "5036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Michael Shoesmith, QMHA
• Darnelle M Shuckhart
• Laura Shuldberg, PHARMD
• Elliott D Shurtz
• Sheila Louise Sidraya, LCSW, CADC
• Christi R Siedlecki, RN
• Kathleen Siegel, LMT
• Claire Dipietro Sierra
• Cindy A Silva
• Dawn Silverberg

• Physical Therapy Assistant in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.