Individual provider Active NPI

Elizabeth Beaver, WHNP-BC

  • Women's Health Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1174915839
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP7665 Issued in AZ
Practice address
655 S. Dobson Rd
Ste 101
Chandler, AZ 85224
Phone
(480) 782-0993
Fax
(855) 329-8939
NPI assigned
Mar 4, 2015
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP7665 AZ Primary

Addresses

Primary practice location

655 S. Dobson Rd
Ste 101
Chandler, AZ 85224

Mailing address

655 S. Dobson Rd
Ste 101
Chandler, AZ 85224
Phone (480) 459-2555

Other identifiers 1

IdentifierTypeStateIssuer
421989MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150625000537 AZ Practitioner - Nurse Practitioner 1658682158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lilac Healthcare LLCGroup PAC ID 7911333596, 23 clinicians

Practice addresses (Care Compare)

655 S Dobson Rd
Suite A101
Chandler, AZ 85224-5667
Phone (480) 459-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP7665AZMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lilac Healthcare LLC Obstetrics & Gynecology CurrentSince Apr 18, 2022 Accepting new patients

Locations

655 S Dobson Rd
Ste 101
Chandler, AZ 85224
Phone (480) 459-2555

655 S Dobson Rd
Ste A101
Chandler, AZ 85224
Phone (480) 855-5900

Organizations & group practices 1

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": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1174915839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S. DOBSON RD",
            "address_2": "STE 101",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-459-2555",
            "fax_number": "480-687-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S. DOBSON RD",
            "address_2": "STE 101",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-782-0993",
            "fax_number": "855-329-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP7665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421989",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.