Whitney Beall, PA
Individual provider Active NPI Physician Assistant · Millington, TN
NPI 1033534847 · NPPES record last updated Apr 20, 2022
Key facts
- NPI
- 1033534847
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 4925 (TN)
- Practice address
- 8188 US Highway 51 N
Millington, TN 38053-1750 - Phone
- (901) 614-4455
- Fax
- (901) 614-4526
- NPI assigned
- Mar 3, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220426000730 | TN | Practitioner - Physician Assistant | 3274757927 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA23286 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients |
Locations
8188 US Highway 51 N
Millington, TN 38053
Phone (901) 614-4455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4925 | TN | Yes |
| Physician Assistant | 363A00000X | PA23286 | CA |
Addresses
Primary practice location
8188 US Highway 51 N
Millington, TN 38053-1750
Mailing address
8188 US Highway 51 N
Millington, TN 38053-1750
Phone (901) 614-4455
Other practice location 1
4140 Jade St Ste 100
Capitola, CA 95010-3940
Phone (831) 475-4024
Other names
- Whitney Konz
Other providers in Millington, TN
- Philip Joseph Baker
- Michael F Ballard
- Kimberly Anita Banks
- Bonnie Lou Barakat-Smith
- Valerie L Barfield
- Jacob Allen Beaty
- Bio-Medical Applications of Tennessee, Inc.
- Cheryl A Bird
- Janet Alicia Black
- Blue Odyssey Transportation
All providers in Millington, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.