Individual provider Active NPI

David Lance Beadleston, DVM

  • Veterinarian
  • Niwot, CO
National Provider Identifier
1235481359
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
4375 Issued in CO
Practice address
8930 Marathon Rd
Niwot, CO 80503-8663
Phone
(303) 682-2437
Fax
(303) 485-6105
NPI assigned
Oct 12, 2012
Last updated
Oct 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 4375 CO Primary

Addresses

Primary practice location

8930 Marathon Rd
Niwot, CO 80503-8663

Mailing address

8930 Marathon Rd
Niwot, CO 80503-8663
Phone (303) 682-2437

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4375COMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1235481359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 MARATHON RD",
            "city": "NIWOT",
            "state": "CO",
            "postal_code": "805038663",
            "telephone_number": "303-682-2437",
            "fax_number": "303-485-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 MARATHON RD",
            "city": "NIWOT",
            "state": "CO",
            "postal_code": "805038663",
            "telephone_number": "303-682-2437",
            "fax_number": "303-485-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEADLESTON",
        "first_name": "DAVID",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "CO",
            "license": "4375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niwot, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.