Mark Stockton Beveridge, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R7172 Issued in TX

Practice address

220 Athens Way # 240
Nashville, TN 37228-1311

Phone

(833) 208-7770

NPI assigned

Apr 13, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Locations

Interoperability endpoints

• Direct secure messaging: stockton.beveridge.1@27760.direct.athenahealth.com

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.

• Imagine Pediatrics of North Carolina, PLLC

  • Pediatrics Physician
  • Durham, NC
  • NPI 1538922638

  Pediatrics

  NPD
• Complex Care Medical Services Corporation

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1013256098

  Pediatrics

  NPD (past)
• Imagine Pediatrics of Florida LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1104542232

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1477949873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 ATHENS WAY # 240",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281311",
            "telephone_number": "833-208-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ATHENS WAY # 240",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281311",
            "telephone_number": "833-208-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1935 Medical District Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357701",
            "country_code": "US",
            "telephone_number": "615-936-2555",
            "fax_number": "615-936-2419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Southwest Fwy Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770277525",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3109 W Dr Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076260",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEVERIDGE",
        "first_name": "MARK",
        "middle_name": "STOCKTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2024-06-21",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LH0002X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "R7172",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "R7172",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R7172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391078803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon E Betts, M.D.
• Alissa Beuerlein, PH.D., LPC-MHSP
• James Beuerlein Jr., D.C.
• Linda Beuscher, APN
• Matthew J Beuter, MD
• Nancy G Beveridge, M.D
• Kayce Renee Beville, RN
• Robel Tesfaye Beyene, M.D.
• Seyum Tsegaye Beyene, FNP-BC
• Bruce Beyer, MD

• All providers in Nashville, TN
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.