Individual provider Active NPI

Denise L Beckers, PTA

  • Physical Therapy Assistant
  • Overland Park, KS
National Provider Identifier
1790036374
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2011021955 Issued in MO
Practice address
6400 Glenwood St
Suite 111
Overland Park, KS 66202-4028
Phone
(913) 831-2721
NPI assigned
Sep 24, 2012
Last updated
Sep 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2011021955 MO Primary

Addresses

Primary practice location

6400 Glenwood St
Suite 111
Overland Park, KS 66202-4028

Mailing address

4435 Madison Ave
#114
Kansas City, MO 64111-3406
Phone (417) 425-4450

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

LicenseStateTypeSpecialty
2011021955MOMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blake Physical Therapy, PC Current Accepting new patients

Locations

4820 Lincoln Blvd
Marina del Rey, CA 90292
Phone (310) 392-7889

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1790036374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 MADISON AVE",
            "address_2": "#114",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113406",
            "telephone_number": "417-425-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 GLENWOOD ST",
            "address_2": "SUITE 111",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662024028",
            "telephone_number": "913-831-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKERS",
        "first_name": "DENISE",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2011021955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.