NPIMap

Organization Active NPI

Beaver Urgent Care

  • Urgent Care Clinic/Center
  • Beaver, WA
National Provider Identifier
1114619384
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
BEAVER URGENT CARE
Practice address
200361 Highway 101
Beaver, WA 98305-9645
Phone
(360) 640-5601
NPI assigned
May 24, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Jonas Brenden Merrill, PA-CNPI 1013287002
Title
Owner/Provider
Phone
(360) 640-5601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

200361 Highway 101
Beaver, WA 98305-9645

Mailing address

PO Box 128
Beaver, WA 98305-0128
Phone (360) 640-5601

National Provider Directory

National Provider Directory

Locations

200361 Highway 101
Beaver, WA 98305
Phone (360) 640-5601

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1114619384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "BEAVER",
            "state": "WA",
            "postal_code": "983050128",
            "telephone_number": "360-640-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200361 HIGHWAY 101",
            "city": "BEAVER",
            "state": "WA",
            "postal_code": "983059645",
            "telephone_number": "360-640-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "JONAS",
        "authorized_official_middle_name": "BRENDEN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "360-640-5601",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.