Beechtree Diagnostics LLP

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MED00041092015 Issued in UT

Legal business name

BEECHTREE DIAGNOSTICS LLP

Practice address

12351 S Gateway Park PL Ste D-700
Draper, UT 84020-9581

Phone

(801) 893-2773

Fax

(801) 683-9907

NPI assigned

Dec 2, 2015

Organization subpart

Yes

Parent organization

LABPARTNER LLCAs reported in NPPES

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

Authorized official

Name

Gary Dawson

Title

VP of Finance

Phone

(801) 890-7971

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Beechtree Diagnostics LLP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Beechtree Diagnostics LLP

  • Clinical Medical Laboratory
  • Anthem, AZ
  • NPI 1396202602
  NPD tax ID

Locations

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1215302245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35146",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245146",
            "telephone_number": "801-893-2773",
            "fax_number": "801-683-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 S GATEWAY PARK PL STE D-700",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209581",
            "telephone_number": "801-893-2773",
            "fax_number": "801-683-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEECHTREE DIAGNOSTICS LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LABPARTNER LLC",
        "enumeration_date": "2015-12-02",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "801-890-7971"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "UT",
            "license": "MED00041092015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215302245",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "46D2103212",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Wayne Beck, PHARMD, BCPS
• Kirsten Beck
• Lacie Beck
• Joslyn Beckstead
• John Thomas Bedford Jr., D.P.T., O.C.S
• Beechtree Molecular Lab LLC
• Behavioral Health Solutions of Utah
• Andrew Charles Behunin, D.O.
• Kendyl Bell
• Madison Lynn Bell, RN

• Clinical Medical Laboratory in Draper, UT
• Providers in Draper, UT by specialty
• Clinical Medical Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.