Constance Beckom, MD
Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Ranson, WV
NPI 1477540938 · NPPES record last updated Jan 8, 2021
Key facts
- NPI
- 1477540938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- 26847 (WV)
- Practice address
- 203 E 4TH Ave
Ranson, WV 25438-1617 - Phone
- (304) 725-6343
- Fax
- (304) 725-5523
- NPI assigned
- Sep 30, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160506000681 | WV | Practitioner - Geriatric Medicine |
4688770746 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26847 | WV | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Healthcare Physicians, Inc. | Family Medicine | Current |
Accepting new patients |
| University Healthcare Physicians Inc | Current |
Accepting new patients | |
| Alignmed Partners, PC | Current |
Accepting new patients | |
| Linda L. Johnson MD, LTD | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1 Diane Dr
Fort Ashby, WV 26719
Phone (304) 298-3602
171 Taylor St
Harpers Ferry, WV 25425
Phone (304) 535-6343
101 13th St
Huntington, WV 25701
Phone (304) 525-7622
2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436
203 E 4th Ave
Ranson, WV 25438
Phone (304) 535-6343
203 E 4th Ave
#B
Ranson, WV 25438
Phone (304) 725-2773
Interoperability endpoints
- constance.beckom.1@19278.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 14590 | NV | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 26847 | WV | Yes |
Addresses
Primary practice location
203 E 4TH Ave
Ranson, WV 25438-1617
Mailing address
203 E 4TH Ave
Ranson, WV 25438-1617
Phone (304) 725-6343
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477540938 | Medicaid | WV |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cbeckom42457@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | cbeckom42457@direct.wvuhsdirect.com | Health Information Exchange (HIE) |
Other providers in Ranson, WV
- Aurora Counseling Center
- Luke Badley
- Karen Elizabeth Baird-Miller
- Breona C Barr
- Joseph William Beakey
- Carolynn Bell
- Martina E Best
- Andrew Covington Black
- Krista Blaylock
- Sheila Marie Blazer
All providers in Ranson, WV · Geriatric Medicine (Family Medicine) Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.