Beach Pediatric Therapy LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

BEACH PEDIATRIC THERAPY LLC

Practice address

405 Bear Tree CT
Moncks Corner, SC 29461-7475

Phone

(814) 598-8434

NPI assigned

Sep 6, 2024

Last updated

Sep 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah Elizabeth Gleason, COTA/LNPI 1982369757

Title

Owner

Phone

(814) 598-8434

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cynthia Lynn Krizauskas, OT R/L

  • Occupational Therapist
  • Port Orchard, WA
  • NPI 1710350939

  SC

  Medicare reassignment NPD
• Sarah Gleason, COTA/L

  • Occupational Therapy Assistant
  • Wellsville, NY
  • NPI 1982369757
  NPD Authorized official

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1760217814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BEAR TREE CT",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294617475",
            "telephone_number": "814-598-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BEAR TREE CT",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294617475",
            "telephone_number": "814-598-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-598-8434",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5855964011",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Ballentine, PHARMD
• Mariquetta Patrice Barnett
• Sarah Leigh Barnhart, PHARMD
• Mardell Bates
• Jennifer Baughman
• Jennifer R. Beaujon, MA, LPC, NCC
• Yongmei Bellack, MA
• Benchmark Healthcare Services LLC
• Holly A. Bender
• Kayla B Bennett

• Pediatric Occupational Therapist in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Pediatric Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.