Mary Lee Beck, NP
Individual provider Active NPI Family Nurse Practitioner · Kingman, AZ
NPI 1629327010 · NPPES record last updated Aug 26, 2024
Key facts
- NPI
- 1629327010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP5580 (AZ)
- Practice address
- 2501 N Stockton Hill Rd Ste 108
Kingman, AZ 86401-4140 - Phone
- (928) 255-5050
- Fax
- (888) 571-5897
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yourtime Psychiatry and Medical Cannabis LLC
Practice addresses (Care Compare)
15605 59TH PL N
Plymouth, MN 55446-3677
Phone (612) 458-3374
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130409000462 | MN | Practitioner - Nurse Practitioner | 3375789704 | Reassigns benefits to 1 organization |
| I20150304001788 | AZ | Practitioner - Nurse Practitioner | 3375789704 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP5580 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yourtime Psychiatry and Medical Cannabis LLC | Current |
Accepting new patients | |
| Raghav LLC | Current |
Accepting new patients | |
| Prescott Healthcare Solutions LLC | Family Medicine | Current |
Accepting new patients |
| Southwest Behavioral Health | Past | Accepting new patients | |
| Southwest Behavioral Health Services, Inc. | Past |
Accepting new patients |
Locations
2500 Canyon Rd
Ste A1
Bullhead City, AZ 86442
Phone (928) 704-4499
2501 N Stockton Hill Rd
Ste 10
Kingman, AZ 86401
2501 N Stockton Hill Rd
Kingman, AZ 86401
2501 N Stockton Hill Rd
Ste 108
Kingman, AZ 86401
Phone (928) 255-5050
3151 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 458-7583
12361 W Bola Dr
Ste 109
Surprise, AZ 85378
Phone (623) 227-1000
1001 E Hebron Pkwy
Ste 118347
Carrollton, TX 75010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP5580 | AZ | |
| Family Nurse Practitioner | 363LF0000X | AP5580 | AZ | Yes |
Addresses
Primary practice location
2501 N Stockton Hill Rd Ste 108
Kingman, AZ 86401-4140
Mailing address
2501 N Stockton Hill Rd Ste 108
Kingman, AZ 86401-4140
Phone (928) 255-5050
Other providers in Kingman, AZ
- Kaylene Barrus
- Nathan Ray Bartholomew
- Anne Marie Bathauer
- Battle Born Anesthesia Associates LTD
- Cortney Dawn Bautista
- Jacob Daniel Beckstrand
- Brent J Bedke
- Scott A Bell
- Blair Glee Berg
- Annika Jeanette Bergeson
All providers in Kingman, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.