James Beam
Individual provider Active NPI Physical Therapist · Trumbull, CT
NPI 1962590786 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962590786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 888 White Plains Rd
Trumbull, CT 06611-4552 - Phone
- (203) 459-1133
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050111000905 | CT | Practitioner - Physical Therapist in Private Practice | 7012900855 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connectcare | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
888 White Plains Rd
Trumbull, CT 06611-4552
Mailing address
130 Biro St
Fairfield, CT 06825-5406
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3473 | Other | CT | LICENSE# |
Other providers in Trumbull, CT
- Robert Barnett
- Eileen Markham Barreca
- Ashley Elizabeth Batchelder
- Daniel Christopher Baxter
- Marisa Beals
- Andrew Beck
- Victoria R. Beckett
- Steven D Beckoff
- Michelle Bedson
- Sharon Beesley
All providers in Trumbull, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.