Active NPI
Howard a. Beadner, M.D., P.C.
- Dermatology Physician
- Grand Rapids, MI
National Provider Identifier
1295837730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 4301035366
- Legal business name
- HOWARD A. BEADNER, M.D., P.C.
- Practice address
- 233 Fulton St E
Suite 102
Grand Rapids, MI 49503-3200 - Phone
- (616) 456-6722
- Fax
- (616) 456-6723
- NPI assigned
- Sep 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Howard A. Beadner, M.D.
- Title
- President
- Phone
- (616) 456-6722
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 4301035366 | MI | Primary |
Addresses
Primary practice location
233 Fulton St E
Suite 102
Grand Rapids, MI 49503-3200
Mailing address
233 Fulton St E
Suite 102
Grand Rapids, MI 49503-3200
Phone (616) 456-6722
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0415670 | Other | MI | BLUE CROSS BLUE SHIELD |
| 2100239 | Medicaid | MI |
National Provider Directory
National Provider DirectoryLocations
233 Fulton St E
Ste 102
Grand Rapids, MI 49503
Phone (616) 456-6722
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Grand Rapids, MI
- NPI 1962595199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1295837730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 FULTON ST E",
"address_2": "SUITE 102",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033200",
"telephone_number": "616-456-6722",
"fax_number": "616-456-6723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 FULTON ST E",
"address_2": "SUITE 102",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033200",
"telephone_number": "616-456-6722",
"fax_number": "616-456-6723"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOWARD A. BEADNER, M.D., P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BEADNER",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "616-456-6722",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "MI",
"license": "4301035366",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0415670",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2100239",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.