Active NPI
Charles Barry Beaumont, MD
- Specialist
- Bethlehem, CT
National Provider Identifier
1679910814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 018033
- Practice address
- 36 Arch Bridge Rd
Bethlehem, CT 06751-1611 - Phone
- (860) 483-0975
- Fax
- (203) 266-5522
- NPI assigned
- May 29, 2013
- Last updated
- May 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 018033 | CT | Primary |
Addresses
Primary practice location
36 Arch Bridge Rd
Bethlehem, CT 06751-1611
Mailing address
36 Arch Bridge Rd
Bethlehem, CT 06751-1611
Phone (860) 483-0975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018033 | Other | CT | CT STATE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018033 | CT | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1679910814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 ARCH BRIDGE RD",
"city": "BETHLEHEM",
"state": "CT",
"postal_code": "067511611",
"telephone_number": "860-483-0975",
"fax_number": "203-266-5522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 ARCH BRIDGE RD",
"city": "BETHLEHEM",
"state": "CT",
"postal_code": "067511611",
"telephone_number": "860-483-0975",
"fax_number": "203-266-5522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUMONT",
"first_name": "CHARLES",
"middle_name": "BARRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-29",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CT",
"license": "018033",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CT STATE",
"identifier": "018033",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.