Active NPI
Dan A Beaver, DO
- Family Medicine Physician
- Salem, OR
National Provider Identifier
1619080454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OR DO16464
- Practice address
- 5125 Skyline Rd S
Salem, OR 97306-9427 - Phone
- (503) 361-5400
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OR DO16464 | OR | Primary |
Addresses
Primary practice location
5125 Skyline Rd S
Salem, OR 97306-9427
Mailing address
3400 Deer Lake CT SE
Salem, OR 97317
Phone (503) 588-6919
Other names 1
- Dr. Daniel A Beaver
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OR DO16464 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619080454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DEER LAKE CT SE",
"city": "SALEM",
"state": "OR",
"postal_code": "97317",
"telephone_number": "503-588-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5125 SKYLINE RD S",
"city": "SALEM",
"state": "OR",
"postal_code": "973069427",
"telephone_number": "503-361-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAVER",
"first_name": "DAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "OR DO16464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DANIEL",
"last_name": "BEAVER",
"middle_name": "A",
"prefix": "DR.",
"credential": "DO",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Salem, OR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.