Individual provider Active NPI

Caren Denise Beasley, M.D.

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1114954872
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017-01010 Issued in NC
Practice address
1307 W Wendover Ave
Greensboro, NC 27408
Phone
(336) 832-3110
Fax
(336) 832-3111
NPI assigned
Jun 27, 2006
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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 2017-01010 NC Primary

Addresses

Primary practice location

1307 W Wendover Ave
Greensboro, NC 27408

Mailing address

1307 W Wendover Ave
Greensboro, NC 27408-8117
Phone (336) 832-3110

Other practice location 1

3820 Medical Park Dr
Austell, GA 30106-1110
Phone (770) 948-6041 ext. 203

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbeasley392343@direct.conehealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180328003103 NC Practitioner - Family Practice 8527146984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1307 W Wendover Ave
Greensboro, NC 27408-8117
Phone (336) 832-3110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-01010NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Family Medicine Current Accepting new patients
Moses Cone Physician Services, Inc. Family Medicine CurrentSince Jan 23, 2018 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Jan 23, 2018 Accepting new patients
Moses Cone Physician Services, Inc. Past Accepting new patients

Locations

1307 W Wendover Ave
Greensboro, NC 27408
Phone 3368323110 ext. 33683

300 E Wendover Ave
Fl 4
Greensboro, NC 27401
Phone (336) 663-5038

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

Interoperability endpoints

  • Direct secure messaging: cbeasley392343@direct.conehealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1114954872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088117",
            "telephone_number": "336-832-3110",
            "fax_number": "336-832-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27408",
            "telephone_number": "336-832-3110",
            "fax_number": "336-832-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3820 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061110",
            "country_code": "US",
            "telephone_number": "770-948-6041 x203",
            "fax_number": "770-948-7994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "CAREN",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-01010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbeasley392343@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1307 W Wendover Ave",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.