Active NPI
Walter Beitusch II, CNP
- Family Nurse Practitioner
- New Vienna, OH
National Provider Identifier
1619418324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN.CNP.020600
- Practice address
- 10110 Mad River Rd
New Vienna, OH 45159-9479 - Phone
- (937) 527-6089
- NPI assigned
- Mar 14, 2017
- 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 Nurse Practitioner | 363LF0000X | APRN.CNP.020600 | OH | Primary |
Addresses
Primary practice location
10110 Mad River Rd
New Vienna, OH 45159-9479
Mailing address
10110 Mad River Rd
New Vienna, OH 45159-9479
Phone (937) 527-6089
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)
- Not enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.020600 | OH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489449600000",
"number": "1619418324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10110 MAD RIVER RD",
"city": "NEW VIENNA",
"state": "OH",
"postal_code": "451599479",
"telephone_number": "937-527-6089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10110 MAD RIVER RD",
"city": "NEW VIENNA",
"state": "OH",
"postal_code": "451599479",
"telephone_number": "937-527-6089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEITUSCH",
"first_name": "WALTER",
"name_suffix": "II",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-14",
"last_updated": "2017-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.020600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Vienna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.