Healthcare Provider Details

I. General information

NPI: 1255251237
Provider Name (Legal Business Name): JOSHUA BEAMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 SAINT JOE CENTER RD
FORT WAYNE IN
46825-5042
US

IV. Provider business mailing address

2626 SAINT JOE CENTER RD
FORT WAYNE IN
46825-5042
US

V. Phone/Fax

Practice location:
  • Phone: 260-497-0328
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: