Laurie Jean Beavers, FAMILY NURSE PRACTIT

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209 000817 Issued in IL

Practice address

8590 Saint Lukes Dr
Beardstown, IL 62618-8398

Phone

(217) 323-2242

Fax

(217) 452-7245

NPI assigned

Sep 6, 2006

Last updated

Sep 21, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Laurie Jean Gehm Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cass County Public Health Dept

  dba Cass County Health Clinic

  • Case Management Agency
  • Beardstown, IL
  • NPI 1144703372
  NPD (past)
• Cass County Public Health Dept

  dba Cass County Health Clinic Beardstown

  • Federally Qualified Health Center (FQHC)
  • Beardstown, IL
  • NPI 1942439310
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1386747343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 130",
            "city": "GREENFIELD",
            "state": "IL",
            "postal_code": "62044",
            "telephone_number": "217-368-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8590 SAINT LUKES DR",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626188398",
            "telephone_number": "217-323-2242",
            "fax_number": "217-452-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "LAURIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "FAMILY NURSE PRACTIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209 000817",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209 000817",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370661499007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "GEHM",
            "middle_name": "JEAN",
            "credential": "CFNP, CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beardstown Cu SCH Dist 15
• Beardstown Health and Rehab Center LLC
• Beardstown Health and Rehab Center LLC
• Beardstown Supportive Living LLC
• Beardstown Therapy Clinic
• Amanda J Bechard, MHP
• Kembra Bell, MHP
• Mary Agnes Bigelow, O.D.
• Tierney Birdsell, MHP
• Beth M Blankenship, PTA/L

• Family Nurse Practitioner in Beardstown, IL
• Providers in Beardstown, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.