Jason D. Beaver, MD LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

JASON D. BEAVER, MD LLC

Practice address

2800 Ross Clark Cir Ste 2
Dothan, AL 36301-9917

Phone

(334) 305-1848

Fax

(334) 305-1949

NPI assigned

Feb 7, 2022

Organization subpart

No

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

Authorized official

Name

Jason D Beaver, MDNPI 1740285931

Title

Owner Ao

Phone

(334) 699-7900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason D. Beaver, M.D.

  • Surgery Physician
  • Dothan, AL
  • NPI 1740285931
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1497409775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363019917",
            "telephone_number": "334-305-1848",
            "fax_number": "334-305-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363019917",
            "telephone_number": "334-305-1848",
            "fax_number": "334-305-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON D. BEAVER, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "BEAVER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER AO",
        "authorized_official_telephone_number": "334-699-7900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamison Behavioral Wellness LLC
• Dallarie Jamison, CRNP
• Carmen Jan Liao, M.D.
• Maggie Lynn Janney
• Jason a. Zacks, MD PC
• Hira Javaid, MD
• Chad Anthony Jenkins, MD
• Bruce A. Jenne, P.T.
• Courtney Jenne
• Jonathan Kelsie Jennings, MD

• Surgery Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.