Active NPI
Petran Beard
- Family Medicine Physician
- Tucson, AZ
National Provider Identifier
1205987039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- XXXXXX
- Practice address
- 4175 S Alamo Ave
Davis-Monthan AFB
Tucson, AZ 85707-4402 - Phone
- (520) 228-2719
- NPI assigned
- Jan 16, 2007
- Last updated
- Aug 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | XXXXXX | FL | Primary |
Addresses
Primary practice location
4175 S Alamo Ave
Davis-Monthan AFB
Tucson, AZ 85707-4402
Mailing address
12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XXXXXX | FL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313366400000",
"number": "1205987039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12647 OLIVE BLVD",
"address_2": "SUITE 600",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4175 S ALAMO AVE",
"address_2": "DAVIS-MONTHAN AFB",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857074402",
"telephone_number": "520-228-2719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARD",
"first_name": "PETRAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2011-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "XXXXXX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.