Jill Kelley Beasenburg, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

4236 Issued in SC

Practice address

856 Grannys LN
Awendaw, SC 29429-6060

Phone

(843) 259-4633

Fax

(843) 388-4498

NPI assigned

May 10, 2006

Last updated

May 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Palmetto Children's Therapy, LLC

  • Pediatric Physical Therapist
  • Awendaw, SC
  • NPI 1477503613

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1871543033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 LONG POINT RD UNIT G",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648286",
            "telephone_number": "843-259-4633",
            "fax_number": "843-388-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 GRANNYS LN",
            "city": "AWENDAW",
            "state": "SC",
            "postal_code": "294296060",
            "telephone_number": "843-259-4633",
            "fax_number": "843-388-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASENBURG",
        "first_name": "JILL",
        "middle_name": "KELLEY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "4236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH1534",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Acorn Care Transport LLC
• Lindsay Carr, LPC-A, LPC
• Shonda Nicole Coleman
• Early Advantage, LLC
• Brittney Lynn Farrell, MS, CCC-SLP
• Sarah Beth Ferrillo, N.P.

• Pediatric Physical Therapist in Awendaw, SC
• Providers in Awendaw, SC by specialty
• Pediatric Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.