Jill C Beck, MD

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

R7661 Issued in TX

Practice address

17600 Interstate 45 S
Conroe, TX 77384-5148

Phone

(936) 267-7400

NPI assigned

Nov 28, 2005

Last updated

Jul 29, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1265415913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 INTERSTATE 45 S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773845148",
            "telephone_number": "936-267-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 INTERSTATE 45 S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773845148",
            "telephone_number": "936-267-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Idaho St",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837126267",
            "country_code": "US",
            "telephone_number": "208-381-9590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECK",
        "first_name": "JILL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TX",
            "license": "R7661",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "ID",
            "license": "M7742",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805412000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yessenia Beard
• Richard Vincent Beasley, RN, AGNP-C
• Jill M Beatty, M.D.
• Jason Beauchamp, RPH
• Beautiful Minds Assisted Living LLC
• Becoming You Counseling & Trauma Services
• Christa Leigh Bednarek
• Courtney Ashlynn Bednarek, DC
• Bee & Bee Pediatrics
• Bee Kind Care, LLC

• Pediatric Otolaryngology Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Pediatric Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.