Individual provider Active NPI

Beau Lawrence

  • Physical Therapist
  • Winston Salem, NC
National Provider Identifier
1891387791
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5054 Peters Creek Pkwy Ste 18
Winston Salem, NC 27127-7276
Phone
(336) 771-3900
NPI assigned
Feb 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

5054 Peters Creek Pkwy Ste 18
Winston Salem, NC 27127-7276

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 682-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302000041 NC Practitioner - Physical Therapist in Private Practice 4284040130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of North Carolina, LLCGroup PAC ID 1052609278, 242 clinicians

Practice addresses (Care Compare)

5054 Peters Creek Pkwy
Suite 18
Winston Salem, NC 27127-7276
Phone (336) 771-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Feb 3, 2021 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Feb 3, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

5054 Peters Creek Pkwy
Ste 18
Winston Salem, NC 27127
Phone (336) 771-3900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1891387791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-682-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5054 PETERS CREEK PKWY STE 18",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271277276",
            "telephone_number": "336-771-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "BEAU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.