Kelly Dean Beaumont, PA

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

100872-1206 Issued in UT

Practice address

1240 E 100 S Ste 14
St George, UT 84790-3005

Phone

(435) 628-8232

Fax

(435) 674-7994

NPI assigned

Sep 21, 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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Jerry D Twiggs MD PC

  dba Dixie Pediatrics

  • Pediatric Adolescent Medicine Physician
  • St George, UT
  • NPI 1578763702
  NPD (past)
• Night Light Pediatrics LLC

  • Pediatric Adolescent Medicine Physician
  • St George, UT
  • NPI 1295855914
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548369341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 E 100 S STE 14",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847903005",
            "telephone_number": "435-628-8232",
            "fax_number": "435-674-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E 100 S STE 14",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847903005",
            "telephone_number": "435-628-8232",
            "fax_number": "435-674-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUMONT",
        "first_name": "KELLY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "UT",
            "license": "100872-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kate Beatty, LSAC
• Lauren Elizabeth Beatty
• Robert O Beatty, LCSW
• Shannan Beatty
• Taylor Lyman Beatty, FNP-C
• Beaver Valley Hospital (St. George Rehabilitation)
• Beaver Valley Hospital
• Beaver Valley Hospital (St. George Rehabilitation)
• Beaver Valley Hospital (Red Cliffs Health & Rehab)
• Megan Becenti

• Pediatric Adolescent Medicine Physician in St George, UT
• Providers in St George, UT by specialty
• Pediatric Adolescent Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.