Active NPI
Stephanie Beauregard, P.T.
- Physical Therapist
- Palm Bay, FL
National Provider Identifier
1730295015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT20371
- Practice address
- 5200 Babcock St NE
Ste 401
Palm Bay, FL 32905-4612 - Phone
- (321) 984-9606
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT20371 | FL | Primary |
Addresses
Primary practice location
5200 Babcock St NE
Ste 401
Palm Bay, FL 32905-4612
Mailing address
141 Casseekee TRL
Melbourne, FL 32951-3354
Phone (321) 837-0961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT20371 | Other | FL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20371 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730295015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 CASSEEKEE TRL",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329513354",
"telephone_number": "321-837-0961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 BABCOCK ST NE",
"address_2": "STE 401",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329054612",
"telephone_number": "321-984-9606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUREGARD",
"first_name": "STEPHANIE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT20371",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT20371",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.