Shelby Jace Beattie, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE60330318 Issued in WA

Practice address

228 E Lauridsen Blvd
Port Angeles, WA 98362-7821

Phone

(360) 457-4850

NPI assigned

Jan 23, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1295073377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E LAURIDSEN BLVD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627821",
            "telephone_number": "360-457-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 E LAURIDSEN BLVD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627821",
            "telephone_number": "360-457-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTIE",
        "first_name": "SHELBY",
        "middle_name": "JACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE60330318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Beth Barrett, LMHC
• Matthew Barton, MD
• Satnaam Singh Bassi, MD
• Randell Edward Bauman, MD
• David B Bayne, M.D.
• Shellie Marie Beaudette, LMP
• Anthony H. J Becher IV
• Miranda Lee Beck
• Candace Becker
• Heidi Ann Becker

• All providers in Port Angeles, WA
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.