Leslie Brent Beadling, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME69283 Issued in FL

Practice address

11512 Lake Mead Ave
BLDG 521
Jacksonville, FL 32256-5835

Phone

(904) 807-9747

Fax

(904) 807-9746

NPI assigned

Dec 26, 2005

Last updated

Jun 11, 2014By the provider in NPPES

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 names 1

• Brent Leslie Beadling Other name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brent.beadling@147058998050820.direct.elationemr.com

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD (past)
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529
  NPD (past)

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

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1548247182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11512 LAKE MEAD AVE",
            "address_2": "BLDG 521",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565835",
            "telephone_number": "904-807-9747",
            "fax_number": "904-807-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11512 LAKE MEAD AVE",
            "address_2": "BLDG 521",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565835",
            "telephone_number": "904-807-9747",
            "fax_number": "904-807-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEADLING",
        "first_name": "LESLIE",
        "middle_name": "BRENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-26",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME69283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENT",
            "last_name": "BEADLING",
            "middle_name": "LESLIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beaches Recovery Services LLC
• Beaches Urology PA
• Beacon Pediatric Behavioral Health
• Beacon Respiratory Services, Inc. (Arcadia H.O.M.E.)
• Leslie Beadling, M.D.
• Beajak Inc. (Ihrs)
• Beal Dermatology, PLLC (Jacksonville Dermatology & Cosmetic Surgery)
• Jessica Beal, MS, RMHCI
• Sophia Renee Beal, M.A. CCC-SLP
• Adam Beall, MD

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.