Theresa Beard, RNFA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

R857458 Issued in MS

Practice address

971 Lakeland Dr
Suite 656
Jackson, MS 39216-4643

Phone

(601) 366-6606

Fax

(601) 366-6647

NPI assigned

Dec 16, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• David R Carroll,MD, PLLC

  dba Surgical Specialist of Jackson

  • Specialist
  • Jackson, MS
  • NPI 1124266952
  NPD (past)

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1629307970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 656",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-6606",
            "fax_number": "601-366-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 656",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-6606",
            "fax_number": "601-366-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MS",
            "license": "R857458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Michael Beall, M.D.
• Christopher Michael Bean, M.D.
• Leslie Hart Bear, M.D.
• Beverly A Beard-Rhodes, LCSW
• Jacob Beard
• Oland Steven Bearden, LCSW
• Bearly Articulating
• Sarah Beasley, NP
• Shakyra Gabrielle Beasley
• Kristine Crawford Beattie, M.S., CCC-SLP

• Surgical Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Surgical Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.