Individual provider Active NPI

Beverly Hall Borchers

  • Pediatric Registered Nurse
  • Slidell, LA
National Provider Identifier
1679219992
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
1034549 Issued in LA
Practice address
259 Brakefield St
Slidell, LA 70458-3617
Phone
(985) 643-5166
NPI assigned
May 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0200X 1034549 LA Primary

Addresses

Primary practice location

259 Brakefield St
Slidell, LA 70458-3617

Mailing address

96 Mayers Trce
Slidell, LA 70460-3298
Phone (985) 774-4890

Other identifiers 1

IdentifierTypeStateIssuer
01102022MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL slidell

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1034549LAMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1679219992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 MAYERS TRCE",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704603298",
            "telephone_number": "985-774-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 BRAKEFIELD ST",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704583617",
            "telephone_number": "985-643-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORCHERS",
        "first_name": "BEVERLY",
        "middle_name": "HALL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": "LA",
            "license": "1034549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01102022",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "slidell",
            "affiliation": "N",
            "address_1": "96 Mayers Trce",
            "city": "Slidell",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704603298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.