Individual provider Active NPI

Nathan Edward Beam, D.D.S.

  • Endodontics
  • Fort Mill, SC
National Provider Identifier
1104054550
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7144 Issued in SC
Practice address
936 Market St
Suite 206
Fort Mill, SC 29708-6562
Phone
(803) 548-4400
Fax
(803) 548-4414
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3875 WV
Endodontics 1223E0200X 7144 SC Primary
Endodontics 1223E0200X 9190 NC

Addresses

Primary practice location

936 Market St
Suite 206
Fort Mill, SC 29708-6562

Mailing address

936 Market St
Suite 206
Fort Mill, SC 29708-6562
Phone (803) 548-4400

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7144SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beam Endodontics Endodontics Past Accepting new patients

Organizations & group practices 1

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1104054550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 MARKET ST",
            "address_2": "SUITE 206",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086562",
            "telephone_number": "803-548-4400",
            "fax_number": "803-548-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 MARKET ST",
            "address_2": "SUITE 206",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086562",
            "telephone_number": "803-548-4400",
            "fax_number": "803-548-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAM",
        "first_name": "NATHAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3875",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "7144",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "9190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.