Individual provider Active NPI

Antonet Radawn Beasley, LPN

  • Licensed Practical Nurse
  • Akron, OH
National Provider Identifier
1295015659
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN. 143910 Issued in OH
Practice address
1777 E Waterford CT
715
Akron, OH 44313-8510
Phone
(419) 610-5612
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN. 143910 OH Primary

Addresses

Primary practice location

1777 E Waterford CT
715
Akron, OH 44313-8510

Mailing address

1777 E Waterford CT
715
Akron, OH 44313-8510
Phone (419) 610-5612

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN. 143910OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1295015659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 E WATERFORD CT",
            "address_2": "715",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443138510",
            "telephone_number": "419-610-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 E WATERFORD CT",
            "address_2": "715",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443138510",
            "telephone_number": "419-610-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "ANTONET",
        "middle_name": "RADAWN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN. 143910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.