Individual provider Active NPI

Timothy J Beaumont, MD

  • Anesthesiology Physician
  • North Kansas City, MO
National Provider Identifier
1598862609
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2012003212 Issued in MO
Practice address
2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone
(816) 691-2021
Fax
(816) 346-7690
NPI assigned
Sep 20, 2006
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 7987 ND
Anesthesiology Physician 207L00000X 2012003212 MO Primary

Addresses

Primary practice location

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254

Mailing address

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone (816) 691-2021

Other identifiers 2

IdentifierTypeStateIssuer
10689MedicaidND
209850106MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2012003212MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Cities Anesthesia Associates, PA Anesthesiology Past Accepting new patients
Meritas Health Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1598862609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR STE 240",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163254",
            "telephone_number": "816-691-2021",
            "fax_number": "816-346-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR STE 240",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163254",
            "telephone_number": "816-691-2021",
            "fax_number": "816-346-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUMONT",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ND",
            "license": "7987",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2012003212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10689",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209850106",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.