Individual provider Active NPI

Brent W Beasley, MD

  • Internal Medicine Physician
  • Independence, MO
National Provider Identifier
1043278484
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2023008158 Issued in MO
Practice address
16659 E 23Rd St S
Independence, MO 64055-1922
Phone
(816) 688-6000
Fax
(816) 631-1885
NPI assigned
May 3, 2006
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18452 OK
Internal Medicine Physician 207R00000X 2023008158 MO Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2000163858 MO
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 0426982 KS

Addresses

Primary practice location

16659 E 23Rd St S
Independence, MO 64055-1922

Mailing address

PO Box 740019
Atlanta, GA 30374-0019
Phone (312) 733-9730

Other practice location 1

4444 E 41st St
Tulsa, OK 74135-2527
Phone (918) 619-4400

Other practice location 2

7521 SE 15th St
Midwest City, OK 73110-5425
Phone (405) 453-8004

Other practice location 3

1918 NE 23rd St
Oklahoma City, OK 73111-3328
Phone (405) 453-8000

Other practice location 4

1538 N Lewis Ave
Tulsa, OK 74110-2535
Phone (918) 400-7001

Other practice location 5

2130 SW 59th St
Oklahoma City, OK 73119-7025
Phone (403) 303-7555

Other practice location 6

11511 E 31st St
Tulsa, OK 74146-1908
Phone (918) 400-7002

Other identifiers 6

IdentifierTypeStateIssuer
186249OtherMOCOVENTRY
200189777OtherMOHUMANA
5682498OtherMOAETNA
0401810OtherMOUNITED HEALTHCARE
27634041OtherMOBLUE CROSS BLUE SHIELD
5612302005OtherMOCIGNA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18452OKMDPharmacist
0426982KSMDGeriatric Medicine (Internal Medicine) Physician
2000163858MOMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital Internal Medicine Past Accepting new patients
Lifespace Communities Inc Past Accepting new patients
Saint Luke's Physician Partners, Inc. Geriatric Medicine Past Accepting new patients
University Health Physicians Internal Medicine Past Accepting new patients
Saint Lukes Physician Group II LLC PastSince Dec 1, 2006 Accepting new patients
St Lukes Hospital of Kansas City Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1043278484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740019",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740019",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16659 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640551922",
            "telephone_number": "816-688-6000",
            "fax_number": "816-631-1885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4444 E 41st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741352527",
            "country_code": "US",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-4152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7521 SE 15th St",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731105425",
            "country_code": "US",
            "telephone_number": "405-453-8004",
            "fax_number": "405-561-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1918 NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731113328",
            "country_code": "US",
            "telephone_number": "405-453-8000",
            "fax_number": "405-561-4984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1538 N Lewis Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741102535",
            "country_code": "US",
            "telephone_number": "918-400-7001",
            "fax_number": "539-202-5070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2130 SW 59th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731197025",
            "country_code": "US",
            "telephone_number": "403-303-7555",
            "fax_number": "405-561-5615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11511 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741461908",
            "country_code": "US",
            "telephone_number": "918-400-7002",
            "fax_number": "539-502-5130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "BRENT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18452",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2023008158",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2000163858",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "KS",
            "license": "0426982",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "186249",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "200189777",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5682498",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0401810",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "27634041",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5612302005",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.