Bessevelyn M. Tables, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2008016715 Issued in MO

Practice address

1225 Graham Rd Ste C-1340
Florissant, MO 63031-8019

Phone

(314) 953-6801

NPI assigned

Jul 9, 2008

Last updated

Feb 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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 Physicians of St. Luke's, LLC

  • Emergency Medicine Physician
  • Chesterfield, MO
  • NPI 1215359815
  Medicare reassignment
• Fast Track Medical LLC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1568770626
  Medicare reassignment
• Fast Track Urgent Care LLC

  • Urgent Care Clinic/Center
  • Florissant, MO
  • NPI 1912150467
  NPD
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Family Medicine

  NPD (past)
• Physician Specialists of St Lukes LLC

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1235168410

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1225291248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-456-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-1340",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318019",
            "telephone_number": "314-953-6801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2070 Tavel Ct Apt C",
            "address_2": "Apt. C",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631462320",
            "country_code": "US",
            "telephone_number": "314-456-7168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABLES",
        "first_name": "BESSEVELYN",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008016715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Graham Rd Ste C-1340",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra Swanson-Whitworth
• Leah Swartwout, MD
• Stephanie Syler, FNP-BC
• Synergy Medical Transportation LLC
• Kenlicia Tabb, PHARMD, RPH
• Ernst Martin Taeger
• Angela Talton, APRN, FNP-BC
• Yirui Tang
• Kongsak Tanphaichitr, M.D.
• Erica Michelle Tate

• Family Medicine Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.