Darryl K Beasley, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01047397A Issued in IN

Practice address

5215 Holy Cross Parkway
Anesthesia Department
Mishawaka, IN 46645

Phone

(574) 335-5000

NPI assigned

May 19, 2006

Last updated

Dec 30, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• St. Joseph Valley Anesthesia P.C.

  • Anesthesiology Physician
  • Mishawaka, IN
  • NPI 1790738854
  Authorized official Same address or phone
• Surgery Center Anesthsia

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1124032537
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1447203203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1742",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466341742",
            "telephone_number": "574-233-3123",
            "fax_number": "574-233-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PARKWAY",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46645",
            "telephone_number": "574-335-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "DARRYL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01047397A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200222900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beacon Health, LLC (Beacon Imaging Mishawaka)
• Beacon Medical Group, Inc. (Beacon Medical Group Schwartz - Wiekamp)
• Beacon Medical Group, Inc. (Beacon Medical Group Mishawaka)
• Hope Beaird
• Trinity Bean
• Hillary J Beck
• Kevin Patrick Bedford, DDS
• Ermina Begovic
• Jennifer Lynn Behnke
• Mary Lumma Behrens, PT

• Anesthesiology Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; 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.