Mike Beverly

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

1110 18TH St Ste 6
Springfield, OR 97477-4200

Phone

(541) 517-3970

Fax

(458) 201-8188

NPI assigned

May 24, 2024

Last updated

May 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• J Beverly Enterprises, LLC

  dba Remynde Family Health and Wellness

  • Community Health Clinic/Center
  • Springfield, OR
  • NPI 1134993058
  NPD

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1134968464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 18TH ST STE 6",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774200",
            "telephone_number": "541-517-3970",
            "fax_number": "458-201-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 18TH ST STE 6",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774200",
            "telephone_number": "541-517-3970",
            "fax_number": "458-201-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERLY",
        "first_name": "MIKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter D Bernard, MD
• Brock Daryl Bernsten, MD
• Ruthie Faye Berrell, RN
• Better Horizons in-Home Care, Inc
• Jamie Beverly
• Ann Joleen Bezuk
• Elizabeth Ashley Martin Bhatta, AGACNP-BC
• Tejinder P Bhullar
• Lloyd David Biby, M.D.
• Tessa Elena Sabina Biehl, THW

• Health & Wellness Coach in Springfield, OR
• Providers in Springfield, OR by specialty
• Health & Wellness Coach in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.