=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215072954
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET JEANINE BEARD MSPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2007
-----------------------------------------------------
Last Update Date | 06/26/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1213 N BELT HWY STE H
-----------------------------------------------------
City | SAINT JOSEPH
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64506-2485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-279-7778
-----------------------------------------------------
Fax | 866-245-8064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1213 N BELT HWY STE H
-----------------------------------------------------
City | SAINT JOSEPH
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64506-2485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-279-7778
-----------------------------------------------------
Fax | 816-279-8788
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 100007
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------