Active NPI
Barry Bean, DPM
- Podiatrist
- Southfield, MI
National Provider Identifier
1336179506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- BB000712
- Practice address
- 21721 W 11 Mile Rd
Southfield, MI 48076-3717 - Phone
- (248) 355-4888
- Fax
- (313) 355-2565
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | BB000712 | MI | Primary |
Addresses
Primary practice location
21721 W 11 Mile Rd
Southfield, MI 48076-3717
Mailing address
21721 W 11 Mile Rd
Southfield, MI 48076-3717
Phone (248) 355-4888
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4856318250 | Other | MI | BCBSM |
| 1507818 | Medicaid | MI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BB000712 | MI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1336179506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21721 W 11 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763717",
"telephone_number": "248-355-4888",
"fax_number": "313-355-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21721 W 11 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763717",
"telephone_number": "248-355-4888",
"fax_number": "313-355-2565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAN",
"first_name": "BARRY",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "BB000712",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "4856318250",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1507818",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.