Active NPI
Michael Warren Beasley, M.D.
- Emergency Medicine Physician
- West Branch, MI
National Provider Identifier
1205879871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MB047056
- Practice address
- 611 Court St
West Branch, MI 48661-9390 - Phone
- (989) 345-7000
- Fax
- (989) 345-7479
- NPI assigned
- Jun 13, 2006
- Last updated
- Oct 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MB047056 | MI | Primary |
Addresses
Primary practice location
611 Court St
West Branch, MI 48661-9390
Mailing address
611 Court St
West Branch, MI 48661-9390
Phone (989) 345-7000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205879871 | Medicaid | MI | |
| 1205879871 | Other | MI | BC BS MI |
| 4069094 | Medicaid | MI | |
| 4329021 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB047056 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodland Health Care Services PC | Emergency Medicine | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- West Branch, MI
- NPI 1578501292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254960000000",
"number": "1205879871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 COURT ST",
"city": "WEST BRANCH",
"state": "MI",
"postal_code": "486619390",
"telephone_number": "989-345-7000",
"fax_number": "989-345-7479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 COURT ST",
"city": "WEST BRANCH",
"state": "MI",
"postal_code": "486619390",
"telephone_number": "989-345-7000",
"fax_number": "989-345-7479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEASLEY",
"first_name": "MICHAEL",
"middle_name": "WARREN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2009-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "MB047056",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1205879871",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS MI",
"identifier": "1205879871",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4069094",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4329021",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Branch, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.