Individual provider Active NPI

John W Beem, M.D.

  • Ophthalmology Physician
  • Wyomissing, PA
National Provider Identifier
1104806884
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD006864E Issued in PA
Practice address
1 Granite Point Dr
Suite 100
Wyomissing, PA 19610-1986
Phone
(610) 378-1344
Fax
(610) 378-5159
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD006864E PA Primary

Addresses

Primary practice location

1 Granite Point Dr
Suite 100
Wyomissing, PA 19610-1986

Mailing address

1 Granite Point Dr
Suite 100
Wyomissing, PA 19610-1986
Phone (610) 378-1344

Other identifiers 1

IdentifierTypeStateIssuer
0669188MedicaidPA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD006864EPAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1104806884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR",
            "address_2": "SUITE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101986",
            "telephone_number": "610-378-1344",
            "fax_number": "610-378-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR",
            "address_2": "SUITE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101986",
            "telephone_number": "610-378-1344",
            "fax_number": "610-378-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEM",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD006864E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0669188",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.