Beverly R Baldwin, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704313314 Issued in MI

Practice address

7310 Garden LN
Portage, MI 49002-4458

Phone

(269) 459-6010

NPI assigned

Mar 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1255926259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 GARDEN LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024458",
            "telephone_number": "269-584-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 GARDEN LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024458",
            "telephone_number": "269-459-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "BEVERLY",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012645A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704313314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Victoria Baeza
• Mary Jean Baggerman, MA
• Rachel Bailey, NP-C
• Sydnee Baker
• Heather Bakken
• Natalie Balkema
• Ryan Ball, DC
• Nicole Lorraine Banks, H.A.S
• William Baranski, NURSE PRACTITIONER
• Katherine Barber

• Family Nurse Practitioner in Portage, MI
• Providers in Portage, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.