Shepherd Lee Beasley, C.PED

Primary specialty

Orthotic FitterTaxonomy code 225000000X

License

PED129 Issued in FL

Practice address

2311 Santa Barbara Blvd
Suite 105
Cape Coral, FL 33991-4394

Phone

(239) 458-3360

Fax

(239) 242-1095

NPI assigned

Jan 9, 2007

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Black Eyed Peas Investments, Inc.

  dba Foot Solutions.

  • Customized Equipment (DME)
  • Cape Coral, FL
  • NPI 1487848206
  NPD (past) Authorized official

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1518016492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 SANTA BARBARA BLVD",
            "address_2": "SUITE 105",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339914394",
            "telephone_number": "239-458-3360",
            "fax_number": "239-242-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 SANTA BARBARA BLVD",
            "address_2": "SUITE 105",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339914394",
            "telephone_number": "239-458-3360",
            "fax_number": "239-242-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "SHEPHERD",
        "middle_name": "LEE",
        "credential": "C.PED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "FL",
            "license": "PED129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie L Bayer, RBT
• Vladimir Bazo Garcia
• Andrea Lynn Beall, PHARMD, BCPS, BCPP
• Lauren Beall, PHARMD
• Kimberlee Beans
• Johanna A Beaty, LMT
• Sabine Beaugris, P.A.
• Jack G. Beaulieu, M.D.
• Jasmin Beauzieux
• Bebos Development Services LLC

• Orthotic Fitter in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Orthotic Fitter in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.