Verniece Beavers, NP
Individual provider Active NPI Nurse Practitioner · Pine Bluff, AR
NPI 1245512185 · NPPES record last updated Jun 29, 2024
Key facts
- NPI
- 1245512185
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- A006164 (AR)
- Practice address
- 620 S Laurel St
Pine Bluff, AR 71601-4859 - Phone
- (870) 534-4900
- Fax
- (870) 534-4906
- NPI assigned
- Sep 16, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Good Health Medical PLLC
Practice addresses (Care Compare)
287 E Hunt Hwy
Suite 105
San Tan Valley, AZ 85143-5096
Phone (480) 677-8282
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191031002635 | AZ | Practitioner - Nurse Practitioner | 5991037509 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A006164 | AR | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Health Medical, PLLC | Current | Accepting new patients | |
| Good Health Medical, PLLC | Current |
Accepting new patients | |
| Good Health Medical, PLLC | Current |
Accepting new patients | |
| Good Health Medical, PLLC | Past | Accepting new patients |
Locations
3100 N Alma School Rd
Chandler, AZ 85224
Phone (480) 255-5983
261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888
428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400
10613 W Olive Ave
Ste 200
Peoria, AZ 85345
4025 E Chandler Blvd
Ste 42
Phoenix, AZ 85048
287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282
Interoperability endpoints
- https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | A006164 | AR | Yes |
Addresses
Primary practice location
620 S Laurel St
Pine Bluff, AR 71601-4859
Mailing address
11964 W Fillmore St
Avondale, AZ 85323-7200
Phone (870) 718-6819
Other providers in Pine Bluff, AR
- Melissa Battles
- Baugh Eyecare Associates, PA
- Jason A Baugh
- Tom G Baxley
- Janet Bean
- Jacqueline Beckwith
- Tad L. Beene
- Carl Hendrick Bell Jr.
- Katrina Bell
- Latisha Nicole Bell
All providers in Pine Bluff, AR · Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.