John Gregory Beauclair, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

5218 Issued in ND

Practice address

3838 12TH Ave N
Fargo, ND 58102-2931

Phone

(701) 234-4700

Fax

(701) 234-4757

NPI assigned

Jul 18, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jbeauclair1841574@direct.sanfordhealth.org

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1477571172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 12TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022931",
            "telephone_number": "701-234-4700",
            "fax_number": "701-234-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 12TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022931",
            "telephone_number": "701-234-4700",
            "fax_number": "701-234-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCLAIR",
        "first_name": "JOHN",
        "middle_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "ND",
            "license": "5218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15009",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbeauclair1841574@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "3838 12th Ave N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581022931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David M Beard, MD,
• Debra A Beard, MD
• Jeanne C Beare, FNP
• Ronald Beare, CRNA
• Taylor Marie Bearinger, MS, LAPC
• Samantha Beaudry
• Beauty in the Struggle, Inc.
• Heather Becher, RN
• Nicholas Becher, PHARMD
• Sadie Becher, APRN CRNA

• Occupational Medicine Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Occupational Medicine Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.