Brian R Beatty, PT

Individual provider Active NPI Physical Therapist · Carrboro, NC

NPI 1922189042 · NPPES record last updated Jul 23, 2015

Key facts

NPI
1922189042
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2827 (NC)
Practice address
304 W Weaver St
Ste 103
Carrboro, NC 27510-2084
Phone
(919) 942-0240
Fax
(919) 942-0280
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2827NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proaxis Therapy SC, LLC Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2827 NC Yes

Addresses

Primary practice location

304 W Weaver St
Ste 103
Carrboro, NC 27510-2084

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers

IdentifierTypeStateIssuer
14105OtherNCBLUE CROSS BLUE SHIELD

Other providers in Carrboro, NC

All providers in Carrboro, NC · Physical Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.