Robin G Beaver

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

84 Ridge Ave
Berea, KY 40403-1880

Phone

(859) 985-0252

Fax

(859) 228-0231

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013077296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 RIDGE AVE",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031880",
            "telephone_number": "859-985-0252",
            "fax_number": "859-228-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 RIDGE AVE",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031880",
            "telephone_number": "859-985-0252",
            "fax_number": "859-228-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "ROBIN",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBIS PROVIDER",
            "identifier": "01556",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Berea Area Development LLC

• All providers in Berea, KY
• Case Manager/Care Coordinator in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.