Experience Physical Therapy and Wellness, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

EXPERIENCE PHYSICAL THERAPY AND WELLNESS, LLC

Practice address

720 37TH St S
Birmingham, AL 35222-3206

Phone

(205) 276-0308

NPI assigned

Apr 21, 2025

Organization subpart

No

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

Authorized official

Name

Lavon BeardNPI 1073093761

Title

Ceo

Phone

(205) 276-0308

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lavon Beard, PT

  • Physical Therapist
  • Hoover, AL
  • NPI 1073093761
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1942096474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MILL RUN LN",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352261834",
            "telephone_number": "205-276-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 37TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352223206",
            "telephone_number": "205-276-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "LAVON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-276-0308"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Physical Therapy Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.