Individual provider Active NPI

John R. Beck, M.D.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1083686158
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
105823 Issued in MO
Practice address
11123 S Towne SQ
Ste. E
Saint Louis, MO 63123-7816
Phone
(314) 487-4537
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36087806 IL
Emergency Medicine Physician 207P00000X 105823 MO Primary

Addresses

Primary practice location

11123 S Towne SQ
Ste. E
Saint Louis, MO 63123-7816

Mailing address

834 State St
Chester, IL 62233-1640
Phone (314) 771-3153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20061018000057 IL Practitioner - Family PracticePractitioner - Emergency Medicine 3678579489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36087806ILMDEmergency Medicine Physician
105823MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Hospital District CurrentSince Oct 22, 2012 Accepting new patients
Pana Community Hospital Association Current Accepting new patients
Crawford Hospital District Current Accepting new patients
Crawford Hospital District CurrentSince Oct 22, 2012 Accepting new patients

Locations

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1083686158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 STATE ST",
            "city": "CHESTER",
            "state": "IL",
            "postal_code": "622331640",
            "telephone_number": "314-771-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11123 S TOWNE SQ",
            "address_2": "STE. E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237816",
            "telephone_number": "314-487-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "36087806",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "105823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.