Clint Beaver, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200901244 Issued in NC

Practice address

106 Corporate Park Dr
Suite 200 & 300
Mooresville, NC 28117-7134

Phone

(704) 235-9090

Fax

(704) 235-9101

NPI assigned

Jun 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gentiva Health Services Home health agency, Hickory, NC, CCN 347300
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
• Duke Health Lake Norman Hospital Hospital, Mooresville, NC, CCN 340129
• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1346805660
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Hickory, NC
  • NPI 1316974272
  Care Compare affiliation
• Duke Health Lake Norman Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Mooresville, NC
  • NPI 1114731064
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1558565838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CORPORATE PARK DR",
            "address_2": "SUITE 200 & 300",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281177134",
            "telephone_number": "704-235-9090",
            "fax_number": "704-235-9101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Fairview Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179508",
            "country_code": "US",
            "telephone_number": "423-343-7018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Plantation Ridge Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179238",
            "country_code": "US",
            "telephone_number": "704-316-1635",
            "fax_number": "704-316-1636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "CLINT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "200901244",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200901244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915044",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CBEAVER20327@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "130 Plantation Ridge Dr",
            "address_2": "Suite 100",
            "city": "Mooresville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281179238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen N Batista, RN
• Duha Bayati
• Laurie Jeanne Beach, MD
• Karen Beam, RPH
• Beatties Ford Road Vocational Trade Center
• Tracy Lorraine Becker, LPC
• Laurel Beezer
• Behavioral Health Services of Lake Norman
• Tonyia Behrendt, LCMHCA
• Belin Intensive in Home Service

• Family Medicine Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.