Individual provider Active NPI

Judith Beach, NP

  • Adult Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1457452963
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
213 Issued in AK
Practice address
3380 C St
Suite 100
Anchorage, AK 99503-3920
Phone
(907) 497-2311
Fax
(907) 497-2310
NPI assigned
Sep 26, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 213 AK Primary

Addresses

Primary practice location

3380 C St
Suite 100
Anchorage, AK 99503-3920

Mailing address

610 Burgundy Dr
Madison, TN 37115-3502
Phone (615) 860-1365

Other identifiers 1

IdentifierTypeStateIssuer
NP61741MedicaidAK

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
213AKMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457452963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BURGUNDY DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371153502",
            "telephone_number": "615-860-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 C ST",
            "address_2": "SUITE 100",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033920",
            "telephone_number": "907-497-2311",
            "fax_number": "907-497-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "JUDITH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AK",
            "license": "213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP61741",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.