Active NPI
Mitchell Drew Beatus, MD
- Infectious Disease Physician
- Memphis, TN
National Provider Identifier
1255378238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- MD26466
- Practice address
- 6019 Walnut Grove Rd
Memphis, TN 38120 - Phone
- (901) 767-3123
- Fax
- (901) 767-3884
- NPI assigned
- May 31, 2006
- Last updated
- Aug 31, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | MD26466 | TN | Primary |
Addresses
Primary practice location
6019 Walnut Grove Rd
Memphis, TN 38120
Mailing address
P O Box 1000 Dept 0364
Memphis, TN 38148-0364
Phone (901) 767-3123
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00121243 | Medicaid | MS | |
| 139226001 | Medicaid | AR | |
| 3090636 | Medicaid | TN | |
| 110105498 | Other | GA | RAILROAD MEDICARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD26466 | TN | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1255378238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 1000 DEPT 0364",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381480364",
"telephone_number": "901-767-3123",
"fax_number": "901-767-3884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6019 WALNUT GROVE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38120",
"telephone_number": "901-767-3123",
"fax_number": "901-767-3884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATUS",
"first_name": "MITCHELL",
"middle_name": "DREW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "TN",
"license": "MD26466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00121243",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139226001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3090636",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110105498",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.