Black Sheep Physical Therapy LLC – Physical Therapist

Key facts

NPI: 1861285264
Entity type: Organization (NPI type 2)
Primary specialty: Physical Therapist 225100000X
Legal business name: BLACK SHEEP PHYSICAL THERAPY LLC
Practice address: 9673 State Route 19
Galion, OH 44833-9695
Phone: (419) 210-5309
NPI assigned: May 28, 2025
Organization subpart: No

Authorized official

Name: Gerald Beck, DPT NPI 1295364677
Title: Owner
Phone: (419) 210-5309

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Gerald Beck Physical Therapist · Ontario, OH · NPI 1295364677

Medicare reassignment NPD Authorized official OH · PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OH

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20251215001153	OH	Part B Supplier - Physical/Occupational Therapy Group in Private Practice	0345734562	Receives reassigned benefits from 1 practitioner Practice locations: Galion, OH

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist Group: 193400000X SINGLE SPECIALTY GROUP	225100000X			Yes

Addresses

Primary practice location

9673 State Route 19
Galion, OH 44833-9695

Mailing address

9673 State Route 19
Galion, OH 44833-9695

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 18, 2025.

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1861285264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9673 STATE ROUTE 19",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448339695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9673 STATE ROUTE 19",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448339695",
            "telephone_number": "419-210-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK SHEEP PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-210-5309",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galion, OH

All providers in Galion, OH · Physical Therapist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.