Individual provider Active NPI

Colby Beecham

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1699349860
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1832 Kempsville Rd
Virginia Beach, VA 23464-6861
Phone
(757) 742-3778
NPI assigned
May 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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 Primary

Addresses

Primary practice location

1832 Kempsville Rd
Virginia Beach, VA 23464-6861

Mailing address

1000 Villas CT
Virginia Beach, VA 23456-6363
Phone (757) 892-4739

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924000663 VA Practitioner - Physical Therapist in Private Practice 2769889377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kbtherapy L.L.C. Current Accepting new patients
Direct Performance Physical Therapy, LLC Physical Therapist CurrentSince May 20, 2021 Accepting new patients
DPPT 2, LLC Physical Therapist Past Accepting new patients

Locations

1832 Kempsville Rd
Virginia Beach, VA 23464
Phone (757) 278-2573

2247 W Great Neck Rd
Ste 101
Virginia Beach, VA 23451
Phone (757) 589-7585

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1699349860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VILLAS CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234566363",
            "telephone_number": "757-892-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 KEMPSVILLE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646861",
            "telephone_number": "757-742-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEECHAM",
        "first_name": "COLBY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.