Ethan Bean, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2015-00236 Issued in NC

Practice address

3040 Hammond Business PL
Suite 105
Raleigh, NC 27603-3666

Phone

(919) 899-6259

Fax

(919) 838-9074

NPI assigned

Nov 2, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• US Department of Veterans Affairs

  • Military Hospital
  • Raleigh, NC
  • NPI 1871977074
  NPD (past)
• Rvlwf Michigan PLLC

  • Multi-Specialty Clinic/Center
  • Novi, MI
  • NPI 1891453684
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1477544021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 HAMMOND BUSINESS PL",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033666",
            "telephone_number": "919-899-6259",
            "fax_number": "919-838-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 HAMMOND BUSINESS PL",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033666",
            "telephone_number": "919-899-6259",
            "fax_number": "919-838-9074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2015-00236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Kathleen Beall, LCSW
• Adriane Beals, RN
• Aysia Beamon
• Carmen Je Vonne Beamon, M.D.
• Regina Wensil Beamon, COTA/L
• Gary Owen Bean, M.D.
• Leah Lynn Bean, MA,MS,BCBA
• Ronda W Bean, MSW LCSW ACSW
• Austin Gregory Beard, PT, DPT
• Megan Brianna Beard

• Psychiatry Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.