Active NPI
Horace E Beasley, AU.D.
- Audiologist
- Lexington, SC
National Provider Identifier
1417990672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 859
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4644 | Other | SC | MEDICAID PTAN |
| SA0817 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centa Medical Group PA | Current | 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.
-
- Otolaryngology Physician
- Lexington, SC
- NPI 1881626133
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.