Individual provider Active NPI

Verniece Beavers, NP

  • Nurse Practitioner
  • Pine Bluff, AR
National Provider Identifier
1245512185
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A006164 Issued in 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
Last updated
Jun 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191031002635 AZ Practitioner - Nurse Practitioner 5991037509 Reassigns benefits to 1 organization

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
Good Health Medical PLLCGroup PAC ID 3779680962, 215 clinicians

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

LicenseStateTypeSpecialty
A006164ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC CurrentSince May 24, 2024 Accepting new patients
Good Health Medical, PLLC CurrentSince May 24, 2024 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

  • FHIR API: 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

Verify at the official NPI Registry.