Individual provider Active NPI

Beverley Jean Springstead, P.A.

  • Physician Assistant
  • Mt Pleasant, TX
National Provider Identifier
1154367159
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
03750 Issued in TX
Practice address
618 N Jefferson Ave
Suite 1
Mt Pleasant, TX 75455-3647
Phone
(903) 575-9500
Fax
(903) 575-9866
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 03750 TX Primary

Addresses

Primary practice location

618 N Jefferson Ave
Suite 1
Mt Pleasant, TX 75455-3647

Mailing address

618 N Jefferson Ave
Suite 1
Mt Pleasant, TX 75455-3647
Phone (903) 575-9500

Other identifiers 1

IdentifierTypeStateIssuer
182504401MedicaidTX

Other names 1

  • Ms. Beverley Jean Peat Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040628000288 TX Practitioner - Physician Assistant 9931185204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
03750TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Late Bloomers, LLC Physician Assistant Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1154367159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N JEFFERSON AVE",
            "address_2": "SUITE 1",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754553647",
            "telephone_number": "903-575-9500",
            "fax_number": "903-575-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N JEFFERSON AVE",
            "address_2": "SUITE 1",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754553647",
            "telephone_number": "903-575-9500",
            "fax_number": "903-575-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRINGSTEAD",
        "first_name": "BEVERLEY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "03750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182504401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLEY",
            "last_name": "PEAT",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mt Pleasant, TX

Sources for this page

Verify at the official NPI Registry.