Individual provider Active NPI

Pamela Beard, LPN

  • Licensed Practical Nurse
  • Wayne, MI
National Provider Identifier
1003049321
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703078688 Issued in MI
Practice address
33120 Forest Park Dr
Wayne, MI 48184-3312
Phone
(734) 634-3340
NPI assigned
Sep 3, 2009
Last updated
Sep 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703078688 MI Primary

Addresses

Primary practice location

33120 Forest Park Dr
Wayne, MI 48184-3312

Mailing address

33120 Forest Park Dr
Wayne, MI 48184-3312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4703078688MIMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1003049321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33120 FOREST PARK DR",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481843312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33120 FOREST PARK DR",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481843312",
            "telephone_number": "734-634-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "PAMELA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703078688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.