Blake R. Beazer, M.D., Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

52480801205 Issued in UT

Legal business name

BLAKE R. BEAZER, M.D., INC

Practice address

2356 N 400 E
Ste. 201
Tooele, UT 84074-3409

Phone

(435) 882-2350

Fax

(435) 882-2039

NPI assigned

Dec 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Blake Richard Beazer, M.D.NPI 1073510012

Title

Medical Doctor

Phone

(435) 882-2358

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Richard Beazer, MD

  • Family Medicine Physician
  • Tooele, UT
  • NPI 1073510012

  Family Medicine, UT

  Medicare reassignment Care Compare group NPD Authorized official
• Marlee K Dalton, CNM, ARPN

  • Family Nurse Practitioner
  • Tooele, UT
  • NPI 1730175761

  Family Medicine, UT

  Medicare reassignment Care Compare group NPD
• Sergio Abarca, M.D.

  • Family Medicine Physician
  • Tooele, UT
  • NPI 1245238617

  Family Medicine

  NPD (past)
• Travis Nathan Allen, PT, DPT

  • Physical Therapist
  • Tooele, UT
  • NPI 1164688347
  NPD (past)
• Lawrence L. Baer, MPT

  • Physical Therapist
  • Millcreek, UT
  • NPI 1346234010
  NPD (past)
• Aaron C. Hall, MPT

  • Physical Therapist
  • Millcreek, UT
  • NPI 1942294616
  NPD (past)
• John Bradford Lewis, DPT

  • Physical Therapist
  • Price, UT
  • NPI 1194913491
  NPD (past)
• Trevor Magee, M.D.

  • Orthopaedic Surgery Physician
  • Salt Lake City, UT
  • NPI 1154543361
  NPD (past)
• Scott Warner, PT, DPT

  • Physical Therapist
  • Erda, UT
  • NPI 1821459025
  NPD (past)

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1184807992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 N 400 E",
            "address_2": "STE. 201",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840743409",
            "telephone_number": "435-882-2350",
            "fax_number": "435-882-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 N 400 E",
            "address_2": "STE. 201",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840743409",
            "telephone_number": "435-882-2350",
            "fax_number": "435-882-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE R. BEAZER, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "BEAZER",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "435-882-2358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "52480801205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000057289",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheldon B Birch, PHARM. D.
• Jamie Bird
• John Lyman Bishop, DMD
• Cristi Bissegger-Cozad, APRN
• George Alva Blackburn, CMHC
• Blue Rock Family Dental, PLLC
• Blue Willow Psychiatry
• Alyssa Bohn
• Amanda Bonacorso, BHCM
• Bonneville Mental Health

• All providers in Tooele, UT
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.