Individual provider Active NPI

Beverly Appl Walsh, DPT

  • Physical Therapist
  • Westminster, MD
National Provider Identifier
1912214636
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23375 Issued in MD
Practice address
511 Jermor LN
Suite 102
Westminster, MD 21157-6151
Phone
(410) 876-8076
Fax
(410) 876-3818
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294690 CA
Physical Therapist 225100000X 23375 MD Primary

Addresses

Primary practice location

511 Jermor LN
Suite 102
Westminster, MD 21157-6151

Mailing address

1609 N Coalter St
Suite 102
Staunton, VA 24401-2552
Phone (540) 213-1320

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (877) 390-6659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190503002340 CA Practitioner - Physical Therapist in Private Practice 2567659410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presidio Sport and Medicine, Inc.Group PAC ID 2466447651, 18 clinicians

Practice addresses (Care Compare)

1162 B Gorgas Ave
San Francisco, CA 94129-1406
Phone (415) 561-6655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294690CAMDPhysical Therapist
23375MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 2, 2019 Accepting new patients
Presidio Sport & Medicine, Inc. Physical Therapist CurrentSince May 4, 2019 Accepting new patients

Locations

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

1162B Gorgas Ave
San Francisco, CA 94129
Phone (415) 561-6655

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1912214636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 N COALTER ST",
            "address_2": "SUITE 102",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012552",
            "telephone_number": "540-213-1320",
            "fax_number": "540-213-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 JERMOR LN",
            "address_2": "SUITE 102",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576151",
            "telephone_number": "410-876-8076",
            "fax_number": "410-876-3818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "877-390-6659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "BEVERLY",
        "middle_name": "APPL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294690",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.