Individual provider Active NPI

Beverly Reeves-Dudley, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1659330215
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
75836 Issued in KS
Practice address
10965 Granada LN
Ste. 102
Overland Park, KS 66211-1469
Phone
(913) 663-3000
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 75836 KS Primary

Addresses

Primary practice location

10965 Granada LN
Ste. 102
Overland Park, KS 66211-1469

Mailing address

8118 Goodman St
Overland Park, KS 66204-3502
Phone (913) 642-4231

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
75836KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology, Chartered Past Accepting new patients
Liberal Anesthesia Consultants LLC Past Accepting new patients
Midwest Anesthesia Associates, PA Past Accepting new patients
Independence Anesthesia Inc Past Accepting new patients
Lawrence Anaesthesia PA Past Accepting new patients

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1659330215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 GOODMAN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043502",
            "telephone_number": "913-642-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10965 GRANADA LN",
            "address_2": "STE. 102",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111469",
            "telephone_number": "913-663-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES-DUDLEY",
        "first_name": "BEVERLY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "75836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.