Active NPI
Kathy Y Beavers, P.A.
- Physician Assistant
- Saint Louis, MO
National Provider Identifier
1336264332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2004008952
- Practice address
- 607 S New Ballas Rd
Suite 2300
Saint Louis, MO 63141-8219 - Phone
- (314) 251-6394
- Fax
- (314) 251-4235
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2004008952 | MO | Primary |
Addresses
Primary practice location
607 S New Ballas Rd
Suite 2300
Saint Louis, MO 63141-8219
Mailing address
607 S New Ballas Rd
Suite 2300
Saint Louis, MO 63141-8219
Phone (314) 251-6394
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004008952 | MO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307059200000",
"number": "1336264332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 S NEW BALLAS RD",
"address_2": "SUITE 2300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418219",
"telephone_number": "314-251-6394",
"fax_number": "314-251-4235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 S NEW BALLAS RD",
"address_2": "SUITE 2300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418219",
"telephone_number": "314-251-6394",
"fax_number": "314-251-4235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAVERS",
"first_name": "KATHY",
"middle_name": "Y",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2011-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2004008952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- Erin M Beaver, MS CGC
- Heidi Alison Beaver, MPH, CGC
- Christopher Andre Beavers, COTA/L
- Jennifer Rebecca Beavers, MSW, LCSW
- Josephine Beavers, RN
- Christine Ann Beavin, MSW, LCSW
- Because We Care Homecare Services LLC
- Because We Care in Home Services LLC
- Gabriella Santi Becerra, MD
- Linda Jane Becher, RN, BSN, CNOR, RNFA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.