Provider Demographics
NPI:1164511069
Name:BEAMER, MICHELLE (DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BEAMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6142 POPES CREEK PLACE
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169
Mailing Address - Country:US
Mailing Address - Phone:571-230-2816
Mailing Address - Fax:
Practice Address - Street 1:480 S COMMERCE AVE STE F
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3093
Practice Address - Country:US
Practice Address - Phone:540-636-3500
Practice Address - Fax:540-636-3502
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010034612Medicaid
VA194082OtherBCBS GROUP # FR
VA4576361OtherGROUP #
VA460032OtherBCBS INDIVIDUAL
VA150718500OtherDEPT OF LABOR
VA277958OtherMAMSI
VA102811OtherBCBS AQUATIC
VA541966445OtherUHC
VA16040OtherCOMMUNITY HEALTH GRP
VA194085OtherBCBS GROUP # WS
VA541966445OtherFIRST HEALTH GROUP #
VA541966445OtherSOUTHERN HEALTH GROUP#
VA650024447OtherRR MEDICARE
VA194083OtherBCBS GROUP # WI
VA102811OtherBCBS AQUATIC
VA541966445OtherFIRST HEALTH GROUP #
VA194082OtherBCBS GROUP # FR