Individual provider Active NPI

Heidi Beougher

  • Licensed Practical Nurse
  • Howard, OH
National Provider Identifier
1174072094
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
162988 Issued in OH
Practice address
12368 Cotton St
Howard, OH 43028
Phone
(740) 504-3632
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 162988 OH Primary

Addresses

Primary practice location

12368 Cotton St
Howard, OH 43028

Mailing address

12368 Cotton Street
Howard, OH 43028
Phone (740) 504-3632

Other identifiers 1

IdentifierTypeStateIssuer
3134576MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
162988OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1174072094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12368 COTTON STREET",
            "city": "HOWARD",
            "state": "OH",
            "postal_code": "43028",
            "telephone_number": "740-504-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 COTTON ST",
            "city": "HOWARD",
            "state": "OH",
            "postal_code": "43028",
            "telephone_number": "740-504-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEOUGHER",
        "first_name": "HEIDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "162988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3134576",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.