Basic Information
| Provider Information | |||||||||
| NPI: | 1164511069 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEAMER | ||||||||
| FirstName: | MICHELLE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6142 POPES CREEK PLACE | ||||||||
| Address2: | |||||||||
| City: | HAYMARKET | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712302816 | ||||||||
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| Practice Location | |||||||||
| Address1: | 480 S COMMERCE AVE STE F | ||||||||
| Address2: | |||||||||
| City: | FRONT ROYAL | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226303093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406363500 | ||||||||
| FaxNumber: | 5406363502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 08/02/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305202439 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 010034612 | 05 | VA | MEDICAID | 194082 | 01 | VA | BCBS GROUP # FR | OTHER | 4576361 | 01 | VA | GROUP # | OTHER | 460032 | 01 | VA | BCBS INDIVIDUAL | OTHER | 150718500 | 01 | VA | DEPT OF LABOR | OTHER | 277958 | 01 | VA | MAMSI | OTHER | 102811 | 01 | VA | BCBS AQUATIC | OTHER | 541966445 | 01 | VA | UHC | OTHER | 16040 | 01 | VA | COMMUNITY HEALTH GRP | OTHER | 194085 | 01 | VA | BCBS GROUP # WS | OTHER | 541966445 | 01 | VA | FIRST HEALTH GROUP # | OTHER | 541966445 | 01 | VA | SOUTHERN HEALTH GROUP# | OTHER | 650024447 | 01 | VA | RR MEDICARE | OTHER | 194083 | 01 | VA | BCBS GROUP # WI | OTHER |