Theodore J Beltz, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

110839 Issued in MO

Practice address

1765 Commercial St
Warsaw, MO 65355-3096

Phone

(660) 438-6800

Fax

(660) 438-6525

NPI assigned

Oct 12, 2005

Last updated

Jun 9, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bothwell Regional Health Center

  dba BHC - Truman Lake

  • Family Medicine Physician
  • Warsaw, MO
  • NPI 1043399371
  NPD
• Bothwell Regional Health Center

  dba Bothwell Physicians Group

  • General Practice Physician
  • Sedalia, MO
  • NPI 1508239781
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1972591030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 14TH ST",
            "address_2": "P O BOX 1706",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015972",
            "telephone_number": "866-678-5627",
            "fax_number": "660-827-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 COMMERCIAL ST",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653553096",
            "telephone_number": "660-438-6800",
            "fax_number": "660-438-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTZ",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "110839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7264017",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS PIN",
            "identifier": "G92800",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PIN",
            "identifier": "26841021",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PIN",
            "identifier": "566161",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244629614",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "G92800",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PIN",
            "identifier": "0102227",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PIN",
            "identifier": "G92800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Back in Action Chiropractic LLC
• Erika Jean Bauer, LPN
• Jared Daniel Beck, D.O.
• Jaima Andrea Becker, FNP-C
• Jessica G Bell, LCSW
• Benton Co Public Health (Benton County Health Dept Hospice)
• Benton Co Public Health
• Benton Co. Public Health
• Benton County Advocates for Developmental Disabilities
• Benton County Health Department

• Family Medicine Physician in Warsaw, MO
• Providers in Warsaw, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.