Individual provider Active NPI

Nancy J Beckman, P.A.

  • Physician Assistant
  • Portage, MI
National Provider Identifier
1295811768
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002186 Issued in MI
Practice address
3200 W Centre Ave
Suite 203
Portage, MI 49024-4889
Phone
(269) 324-0799
Fax
(269) 327-8013
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002186 MI Primary

Addresses

Primary practice location

3200 W Centre Ave
Suite 203
Portage, MI 49024-4889

Mailing address

3200 W Centre Ave
Suite 203
Portage, MI 49024-4889
Phone (269) 324-0799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002186MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: nbeckman32835@direct.bronsonhg.org

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1295811768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W CENTRE AVE",
            "address_2": "SUITE 203",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244889",
            "telephone_number": "269-324-0799",
            "fax_number": "269-327-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W CENTRE AVE",
            "address_2": "SUITE 203",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244889",
            "telephone_number": "269-324-0799",
            "fax_number": "269-327-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKMAN",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.