Individual provider Active NPI

Cheryl Lynn Beighle, MD

  • Pediatrics Physician
  • Marysville, WA
National Provider Identifier
1629046206
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24058 Issued in WA
Practice address
4420 76TH St NE
Marysville, WA 98270-3726
Phone
(360) 651-7492
Fax
(360) 651-7482
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24058 WA Primary

Addresses

Primary practice location

4420 76TH St NE
Marysville, WA 98270-3726

Mailing address

PO Box 5127
Everett, WA 98206-5127

Other practice location 1

4410 106th St SW
Mukilteo, WA 98275-4700
Phone (425) 493-6002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080703000013 WA Practitioner - Pediatric Medicine 5193897379 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24058WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Pediatrics CurrentSince Nov 3, 1986 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Providence Health & Services-Wa CurrentSince Mar 17, 2010 Accepting new patients
Providence Health & Services-Washington CurrentSince Mar 17, 2010 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Nov 3, 1986 Accepting new patients

Locations

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

1717 13th St
Everett, WA 98201
Phone (425) 297-5500

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4420 76th St NE
Marysville, WA 98270
Phone (360) 651-7490

4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: cbeighle127307@wm.providencedirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1629046206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 76TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703726",
            "telephone_number": "360-651-7492",
            "fax_number": "360-651-7482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4410 106th St SW",
            "address_purpose": "LOCATION",
            "city": "Mukilteo",
            "state": "WA",
            "postal_code": "982754700",
            "country_code": "US",
            "telephone_number": "425-493-6002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEIGHLE",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "24058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.