Beverly Jean Cadwallader, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8792 Issued in GA

Practice address

1129 Lake Oconee Pkwy Ste 104
Eatonton, GA 31024-9581

Phone

(762) 220-1962

Fax

(762) 220-1961

NPI assigned

Mar 12, 2014

Last updated

Feb 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Beverly Gallati Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oconee Valley Healthcare IncGroup PAC ID 0446232268, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beverly.cadwallader.1@15507.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/15507/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oconee Valley Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Greensboro, GA
  • NPI 1255433736
  Medicare reassignment Care Compare group NPD
• Oconee Valley Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Greensboro, GA
  • NPI 1144771106
  NPD
• Lake Oconee Medical Associates LLC

  • Adult Medicine Physician
  • Eatonton, GA
  • NPI 1548017031
  NPD (past)
• Reddy Urgent Care - Royston LLC

  dba Royston Reddy Urgent Care

  • Urgent Care Clinic/Center
  • Royston, GA
  • NPI 1093847444
  NPD (past)
• Pacific Perinatal Institute

  • Maternal & Fetal Medicine Physician
  • Colton, CA
  • NPI 1942692777
  NPD (past)

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1003232265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 LAKE OCONEE PKWY STE 104",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249581",
            "telephone_number": "762-220-1962",
            "fax_number": "762-220-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 LAKE OCONEE PKWY STE 104",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249581",
            "telephone_number": "762-220-1962",
            "fax_number": "762-220-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADWALLADER",
        "first_name": "BEVERLY",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "GALLATI",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.