NPIMap

Organization Active NPI

Beckett Springs Physician Group LLC

  • Psychiatry Physician
  • West Chester, OH
National Provider Identifier
1285045922
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BECKETT SPRINGS PHYSICIAN GROUP LLC
Practice address
8614 Shepherd Farm Dr
West Chester, OH 45069-1128
Phone
(513) 942-9500
Fax
(513) 714-7374
NPI assigned
May 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Gina Warren
Title
Director Credentialing & Payor Enro
Phone
(502) 400-8480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

8614 Shepherd Farm Dr
West Chester, OH 45069-1128

Mailing address

8614 Shepherd Farm Dr
West Chester, OH 45069-1128
Phone (513) 942-9500

Other identifiers 1

IdentifierTypeStateIssuer
0103989MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141222002571 OH Part B Supplier - Clinic/Group Practice 1951624097 Receives reassigned benefits from 21 practitioners
1 other NPI on this enrollment
Practice locations: West Chester, OH; Dayton, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1285045922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 SHEPHERD FARM DR",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691128",
            "telephone_number": "513-942-9500",
            "fax_number": "513-714-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8614 SHEPHERD FARM DR",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691128",
            "telephone_number": "513-942-9500",
            "fax_number": "513-714-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECKETT SPRINGS PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "DIRECTOR CREDENTIALING & PAYOR ENRO",
        "authorized_official_telephone_number": "502-400-8480"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103989",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.