Individual provider Active NPI

Horace E Beasley, AU.D.

  • Audiologist
  • Lexington, SC
National Provider Identifier
1417990672
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
859 Issued in SC
Practice address
157 Corley Mill Rd
Lexington, SC 29072-7600
Phone
(803) 256-7041
Fax
(803) 799-4624
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 859 SC Primary

Addresses

Primary practice location

157 Corley Mill Rd
Lexington, SC 29072-7600

Mailing address

157 Corley Mill Rd
Lexington, SC 29072-7600
Phone (803) 256-7041

Other identifiers 2

IdentifierTypeStateIssuer
GP4644OtherSCMEDICAID PTAN
SA0817MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000096 SC Practitioner - Qualified Audiologist 8729160718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centa Medical Group PAGroup PAC ID 9335108778, 9 clinicians

Practice addresses (Care Compare)

157 Corley Mill Rd
Lexington, SC 29072-7600
Phone (803) 256-2483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centa Medical Group PA CurrentSince Feb 14, 2007 Accepting new patients

Locations

9 Richland Medical Park Dr
Ste 510
Columbia, SC 29203
Phone (803) 256-2483

157 Corley Mill Rd
Lexington, SC 29072
Phone (803) 256-2483

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1417990672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CORLEY MILL RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727600",
            "telephone_number": "803-256-7041",
            "fax_number": "803-799-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CORLEY MILL RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727600",
            "telephone_number": "803-256-7041",
            "fax_number": "803-799-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "HORACE",
        "middle_name": "E",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PTAN",
            "identifier": "GP4644",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0817",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.