NPI 1609200633 · live from the CMS NPI Registry
Jacob Lyndon Beltz, MD
Radiology, Vascular & Interventional Radiology in Augusta, GA. National Provider Identifier 1609200633, active.
NPI record
| NPI | 1609200633 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Vascular & Interventional Radiology 2085R0204X |
| Practice location | 1120 15th St, Augusta, GA 30912 |
| Practice phone | 706-721-8623 |
| Mailing address | 1120 15th St # Or6000, Augusta, GA 30912 |
| Enumerated | August 27, 2013 |
| Last updated | August 30, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Vascular & Interventional Radiology primary | 2085R0204X | 90876 (GA) |
| Radiology, Vascular & Interventional Radiology | 2085R0204X | 2022-01243 (NC) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| General Practice | 208D00000X | 90876 (GA) |
| Radiology, Vascular & Interventional Radiology | 2085R0204X | 0101284920 (VA) |
| Radiology, Diagnostic Radiology | 2085R0202X | 0101284920 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.