Valencia Reynolds Beamon, RPT

Individual provider Active NPI Physical Therapist · Camden, MS

NPI 1689808701 · NPPES record last updated May 13, 2014

Key facts

NPI
1689808701
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT3180 (MS)
Practice address
1834 Highway 17
Camden, MS 39045-9005
Phone
(662) 571-4889
Fax
(662) 468-0622
NPI assigned
May 4, 2009
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT3180MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lets Move Physical Therapy and Wellness Inc Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3180 MS Yes

Addresses

Primary practice location

1834 Highway 17
Camden, MS 39045-9005

Mailing address

1834 Highway 17
Camden, MS 39045-9005
Phone (662) 571-4889

Other identifiers

IdentifierTypeStateIssuer
09014160MedicaidMS

Other providers in Camden, MS

All providers in Camden, MS · Physical Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.