Active NPI
Daneith R Beadle
- Physical Therapy Assistant
- Bronx, NY
National Provider Identifier
1780962191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0063011
- Practice address
- 1810 Bruckner Blvd
Apt # 6F
Bronx, NY 10473-3745 - Phone
- (646) 685-9776
- NPI assigned
- Aug 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 0063011 | NY | Primary |
| Physical Therapist | 225100000X | 0362941 | NY |
Addresses
Primary practice location
1810 Bruckner Blvd
Apt # 6F
Bronx, NY 10473-3745
Mailing address
1810 Bruckner Blvd
Apt # 6F
Bronx, NY 10473-3745
Phone (646) 685-9776
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0362941 | NY | MD | Physical Therapist |
| 0063011 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1780962191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1810 BRUCKNER BLVD",
"address_2": "APT # 6F",
"city": "BRONX",
"state": "NY",
"postal_code": "104733745",
"telephone_number": "646-685-9776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1810 BRUCKNER BLVD",
"address_2": "APT # 6F",
"city": "BRONX",
"state": "NY",
"postal_code": "104733745",
"telephone_number": "646-685-9776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEADLE",
"first_name": "DANEITH",
"middle_name": "R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-02",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "0063011",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0362941",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.