Individual provider Active NPI

Keith M Bever Jr., DDS

  • Dentist
  • Mt. Pleasant, MI
National Provider Identifier
1619023017
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18741 Issued in MI
Practice address
2325 Hawthorn Drive
Mt. Pleasant, MI 48858
Phone
(989) 773-9793
Fax
(989) 773-3063
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18741 MI Primary

Addresses

Primary practice location

2325 Hawthorn Drive
Mt. Pleasant, MI 48858

Mailing address

2325 Hawthorn Drive
Mt. Pleasant, MI 48858
Phone (989) 773-9793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151109001413 MI Order and Referring Only - DentistPractitioner - Dentist 0648580316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18741MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1619023017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 HAWTHORN DRIVE",
            "city": "MT. PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-773-9793",
            "fax_number": "989-773-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 HAWTHORN DRIVE",
            "city": "MT. PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-773-9793",
            "fax_number": "989-773-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVER",
        "first_name": "KEITH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "18741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt. Pleasant, MI

Sources for this page

Verify at the official NPI Registry.