Active NPI
Ronald Beahm
- Pediatrics Physician
- Anderson, IN
National Provider Identifier
1063434397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01025307A
- Practice address
- 1210 Medical Arts Blvd
Suite 204
Anderson, IN 46011-3461 - Phone
- (765) 298-4530
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01025307A | IN | Primary |
Addresses
Primary practice location
1210 Medical Arts Blvd
Suite 204
Anderson, IN 46011-3461
Mailing address
1210 Medical Arts Blvd
Suite 204
Anderson, IN 46011-3461
Phone (765) 298-4530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000313194 | Other | IN | ANTHEM |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01025307A | IN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1063434397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 MEDICAL ARTS BLVD",
"address_2": "SUITE 204",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460113461",
"telephone_number": "765-298-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 MEDICAL ARTS BLVD",
"address_2": "SUITE 204",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460113461",
"telephone_number": "765-298-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAHM",
"first_name": "RONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01025307A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000313194",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.