Monte C Beardin, MSPT
Individual provider Active NPI Physical Therapist · Orofino, ID
NPI 1902811789 · NPPES record last updated Oct 2, 2013
Key facts
- NPI
- 1902811789
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-2292 (ID)
- Practice address
- 301 Cedar St
Orofino, ID 83544-9029 - Phone
- (208) 476-4555
- Fax
- (208) 476-5385
- NPI assigned
- Jul 30, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| PT-2292 | ID | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-2292 | ID | Yes |
Addresses
Primary practice location
301 Cedar St
Orofino, ID 83544-9029
Mailing address
301 Cedar St
Orofino, ID 83544-9029
Phone (208) 476-4555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100502784 | Medicaid | NV |
Other providers in Orofino, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2013. 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.