NPIMap

Individual provider Active NPI

Nolan Jackson Beavers, M.D,

  • Family Medicine Physician
  • Belleville, KS
National Provider Identifier
1104921782
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-30225 Issued in KS
Practice address
2337 G St
Belleville, KS 66935-2463
Phone
(785) 527-2217
Fax
(785) 527-5929
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-30225 KS Primary

Addresses

Primary practice location

2337 G St
Belleville, KS 66935-2463

Mailing address

2337 G St
Belleville, KS 66935-2463
Phone (785) 527-2217

Other identifiers 1

IdentifierTypeStateIssuer
100642760CMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000689 KS Practitioner - Family PracticePractitioner - General Practice 0143213637 Reassigns benefits to 3 organizations
Practice locations: Belleville, KS

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains of Republic Co IncGroup PAC ID 0446211684, 8 clinicians

Practice addresses (Care Compare)

2337 G St
Suite 100
Belleville, KS 66935-2462
Phone (785) 527-2217

Hospital & facility affiliations

  • Pivotal Health & Wellness, Inc Home health agency, Courtland, KS, CCN 178138
  • Accessible Home Care, LLC Home health agency, Salina, KS, CCN 178099
  • Inmyhome, a Division of Occk, Inc Home health agency, Salina, KS, CCN 178109
  • Meadowlark Hospice Hospice, Clay Center, KS, CCN 171522
  • Republic County Hospital Hospital, Belleville, KS, CCN 171361
  • Cloud County Health Center Hospital, Concordia, KS, CCN 171349
  • Salina Regional Health Center Hospital, Salina, KS, CCN 170012
  • Jewell County Hospital Hospital, Mankato, KS, CCN 171309
  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
  • Belleville Healthcare and Rehabilitation Center Nursing home, Belleville, KS, CCN 175246
  • Republic County Hospital Nursing home, CCN 17Z361
  • Park Villa Nursing home, Clyde, KS, CCN 175492
  • Sunset Home Inc Nursing home, Concordia, KS, CCN 175422

Merit-based Incentive Payment System (MIPS)

Final score
17.81 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
59.38

Merit-based Incentive Payment System (MIPS)

Final score
35.65 of 100Reported as group
Quality
10.28
Promoting interoperability
100
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-30225KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains of Republic Co., Inc. CurrentSince Jan 1, 2005 Accepting new patients
Great Plains of Republic Co., Inc. Family Medicine CurrentSince Jan 1, 2005 Accepting new patients
Belleville Medical Clinic, P.a. Family Medicine Current Accepting new patients
Great Plains of Republic Co., Inc. CurrentSince Jan 1, 2026 Accepting new patients
Great Plains of Republic Co., Inc. Current Accepting new patients
County of Republic Past Accepting new patients
Jewell County Hospital Past Accepting new patients
Belleville Healthcare and Rehabilitation Center LLC Past Accepting new patients

Locations

2420 G St
Belleville, KS 66935
Phone (785) 527-2254

2337 G St
Ste 100
Belleville, KS 66935
Phone (785) 220-8570

2337 G St
Belleville, KS 66935
Phone (785) 527-2217

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2daa157e-8b5f-4b5c-b571-5b57834b9765/

Organizations & group practices 8

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1104921782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 G ST",
            "city": "BELLEVILLE",
            "state": "KS",
            "postal_code": "669352463",
            "telephone_number": "785-527-2217",
            "fax_number": "785-527-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2337 G ST",
            "city": "BELLEVILLE",
            "state": "KS",
            "postal_code": "669352463",
            "telephone_number": "785-527-2217",
            "fax_number": "785-527-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "NOLAN",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-30225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100642760C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, KS

Sources for this page

Verify at the official NPI Registry.