Maxine Ruth Beatty, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101025142 Issued in VA

Practice address

1212 Lake James Dr
Ste C
Virginia Beach, VA 23464

Phone

(757) 523-4589

Fax

(757) 523-8920

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Maxine Spool Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatrics of Kempsville, P.C.

  • Pediatrics Physician
  • Virginia Beach, VA
  • NPI 1710072145
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1174580377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 LAKE JAMES DR",
            "address_2": "STE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23464",
            "telephone_number": "757-523-4589",
            "fax_number": "757-523-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 LAKE JAMES DR",
            "address_2": "STE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23464",
            "telephone_number": "757-523-4589",
            "fax_number": "757-523-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "MAXINE",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101025142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010107580",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXINE",
            "last_name": "SPOOL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Miranda Chaaban Beard, OD
• Jamie T Beasley, PT
• Meaghan McNeal Beasley, PHARMD
• Susan C Beasley
• Barbara Terese Beatty, LPC, NCC, CSAC
• Hailey Beaudry, PA-C, RDN
• Edith Caroly Beaujon, LSW
• Brian L Beaulieu, PT, MPT, OCS,CMTPT
• Elizabeth Beaume-Vinasco
• Beautiful and Joyful Ventures Inc

• Pediatrics Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.