Jacqueline S Bearden, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27516 Issued in CO

Practice address

5623 W 19TH St
Greeley, CO 80634-2901

Phone

(970) 353-9011

Fax

(970) 353-9135

NPI assigned

Jun 16, 2005

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Banner Medical Group Greeley LLC

  • Multi-Specialty Clinic/Center
  • Johnstown, CO
  • NPI 1386817880
  NPD (past)
• Westlake Family Physicians, PC

  • Primary Care Clinic/Center
  • Greeley, CO
  • NPI 1417942962
  NPD (past)
• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1013912930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 W 19TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342901",
            "telephone_number": "970-353-9011",
            "fax_number": "970-353-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 W 19TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342901",
            "telephone_number": "970-353-9011",
            "fax_number": "970-353-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDEN",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "27516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72506717",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Beaman
• Sarah Bean, SA-C
• Mary Bear
• Jennifer K Beard, BA
• Robert A Beard, MA
• Margaret Mary Beardmore, RDH
• Andrew Beaulieu, M.D.
• Allyson Becerra
• Chelsea L Beck, INTERN
• Josephine Angelina Beck

• All providers in Greeley, CO
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.