Beauvais Manor

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

BEAUVAIS MANOR

Practice address

3625 Magnolia Ave
Saint Louis, MO 63110-4048

Phone

(314) 771-2990

Fax

(314) 771-7790

NPI assigned

Apr 13, 2009

Last updated

Apr 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Marlene Elaine Moore

Title

Rehab Tech.

Phone

(314) 771-2990

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Lisa M Degennaro103 organizations share this tax ID, including this one

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1083857650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MAGNOLIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104048",
            "telephone_number": "314-771-2990",
            "fax_number": "314-771-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MAGNOLIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104048",
            "telephone_number": "314-771-2990",
            "fax_number": "314-771-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUVAIS MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "REHAB TECH.",
        "authorized_official_telephone_number": "314-771-2990",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Beaty, MD
• Olivia Beaubrun, MD
• Tatyana Beaubrun, MD
• Jakeia Kiarra Beauford I
• Beautification Concepts LLC (Vein Skin Care Institute)
• Beauvais Manor Healthcare & Rehab Center
• Beauvais Operator LLC (Beauvais Rehab and Healthcare Center)
• Erin M Beaver, MS CGC
• Heidi Alison Beaver, MPH, CGC
• Christopher Andre Beavers, COTA/L

• Nursing Facility/Intermediate Care Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nursing Facility/Intermediate Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.