Sidney Max Beasley II, ANP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A01629 Issued in AR

Practice address

4001 Wagon Wheel Rd
Springdale, AR 72762-0137

Phone

(479) 725-3000

Fax

(479) 725-3098

NPI assigned

Apr 2, 2007

Last updated

Nov 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1639290323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1065",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727451065",
            "telephone_number": "479-725-3000",
            "fax_number": "479-725-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 WAGON WHEEL RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620137",
            "telephone_number": "479-725-3000",
            "fax_number": "479-725-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "SIDNEY",
        "middle_name": "MAX",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brittney Beavers, MHPP
• Kristen Francis Beavers, D.D.S.
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• J Thaddeus Beck, M.D., F.A.C.P.
• William A Beck, MD

• Family Nurse Practitioner in Springdale, AR
• Providers in Springdale, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.