Individual provider Active NPI

Burton Douglas Beakley, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Birmingham, AL
National Provider Identifier
1619312121
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
840 Montclair Rd
Suite 317
Birmingham, AL 35213-1944
Phone
(205) 592-5135
NPI assigned
May 10, 2013
Last updated
May 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
General Practice Physician 208D00000X 302637 LA

Addresses

Primary practice location

840 Montclair Rd
Suite 317
Birmingham, AL 35213-1944

Mailing address

840 Montclair Rd
Suite 317
Birmingham, AL 35213-1944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20190816002644 TN Practitioner - Anesthesiology 7113151325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in Shreveport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants Exchange, PCGroup PAC ID 2365434297, 152 clinicians

Practice addresses (Care Compare)

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 602-8400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants Exchange, PC CurrentSince Sep 1, 2019 Accepting new patients
Southeastern Retina Associates, P.C. Past Accepting new patients
Baptist Health System, Inc. Past Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste C235
Chattanooga, TN 37403
Phone (423) 602-8400

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1619312121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 MONTCLAIR RD",
            "address_2": "SUITE 317",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 MONTCLAIR RD",
            "address_2": "SUITE 317",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131944",
            "telephone_number": "205-592-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAKLEY",
        "first_name": "BURTON",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "302637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.