Active NPI
Verniece Beavers, NP
- Nurse Practitioner
- Pine Bluff, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- A006164
- Practice address
- 620 S Laurel St
Pine Bluff, AR 71601-4859 - Phone
- (870) 534-4900
- Fax
- (870) 534-4906
- NPI assigned
- Sep 16, 2011
- Last updated
- Jun 29, 2024
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | A006164 | AR | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
287 E Hunt Hwy
Suite 105
San Tan Valley, AZ 85143-5096
Phone (480) 677-8282
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- 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
261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888
3100 N Alma School Rd
Chandler, AZ 85224
Phone (480) 255-5983
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
Organizations & group practices 4
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719619200000",
"number": "1245512185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11964 W FILLMORE ST",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853237200",
"telephone_number": "870-718-6819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 S LAUREL ST",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716014859",
"telephone_number": "870-534-4900",
"fax_number": "870-534-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAVERS",
"first_name": "VERNIECE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-16",
"last_updated": "2024-06-29",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AR",
"license": "A006164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.
- 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.