Marcia Beauchamp, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA000279 Issued in GA

Practice address

1106 Fountain Park Cir
Brunswick, GA 31520-4806

Phone

(912) 262-2151

Fax

(912) 262-2754

NPI assigned

Apr 16, 2018

Last updated

Apr 16, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1922595917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-8907",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 FOUNTAIN PARK CIR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204806",
            "telephone_number": "912-262-2151",
            "fax_number": "912-262-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "MARCIA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA000279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Bates
• Derek Paul Baudoin, M.D.
• Samantha Baxter
• Paul Kevin Beach, M.D.
• Megan Elizabeth Beard
• Hope Becker, RPH
• Keli Lanier Beckum, OTR
• Joseph H. Bee, M.D.
• Haylee Begley, OTR/L
• Behavior Analysis Services (Belinda Montelbano)

• Physical Therapy Assistant in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.