Jonathan Beaudet
Individual provider Active NPI Physical Therapy Assistant · Greenwood Village, CO
NPI 1811397284 · NPPES record last updated Sep 3, 2014
Key facts
- NPI
- 1811397284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 11127A (AZ)
- Practice address
- 8301 E Prentice Ave
Ste 207
Greenwood Village, CO 80111-2903 - Phone
- (303) 322-8300
- NPI assigned
- Sep 3, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11127A | AZ | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 11127A | AZ | Yes |
Addresses
Primary practice location
8301 E Prentice Ave
Ste 207
Greenwood Village, CO 80111-2903
Mailing address
8301 E Prentice Ave
Ste 207
Greenwood Village, CO 80111-2903
NPI Registry JSON
{
"created_epoch": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1811397284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8301 E PRENTICE AVE",
"address_2": "STE 207",
"city": "GREENWOOD VILLAGE",
"state": "CO",
"postal_code": "801112903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8301 E PRENTICE AVE",
"address_2": "STE 207",
"city": "GREENWOOD VILLAGE",
"state": "CO",
"postal_code": "801112903",
"telephone_number": "303-322-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUDET",
"first_name": "JONATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-03",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "11127A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood Village, CO
- Irene Beam
- Rita Beam
- Jacob Beans
- Jimmy Beasley Jr.
- Kaitlyn Beattie
- Philip Erwin Bebeau
- Britta Beblavi
- Lauren Beckman
- Michael K Beggs
- Behavior Buffet LLC
All providers in Greenwood Village, CO · Physical Therapy Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.