Active NPI
Karen L Beasley, MD
- Family Medicine Physician
- Shelby Township, MI
National Provider Identifier
1235188384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301057370
- Practice address
- 15055 22 Mile Rd
Suite 3
Shelby Township, MI 48315-4401 - Phone
- (586) 588-7100
- Fax
- (586) 566-8088
- NPI assigned
- May 8, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301057370 | MI | Primary |
Addresses
Primary practice location
15055 22 Mile Rd
Suite 3
Shelby Township, MI 48315-4401
Mailing address
15055 22 Mile Rd
Suite 3
Shelby Township, MI 48315-4401
Phone (586) 588-7100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4373825 | Medicaid | MI | |
| 700E031610 | Other | MI | BCBS GROUP NUMBER |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. John Hospital and Medical Center | Family 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 and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Saint Clair Shores, MI
- NPI 1386892834
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1235188384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15055 22 MILE RD",
"address_2": "SUITE 3",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483154401",
"telephone_number": "586-588-7100",
"fax_number": "586-566-8088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15055 22 MILE RD",
"address_2": "SUITE 3",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483154401",
"telephone_number": "586-588-7100",
"fax_number": "586-566-8088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEASLEY",
"first_name": "KAREN",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-08",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301057370",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4373825",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP NUMBER",
"identifier": "700E031610",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.