Individual provider Active NPI

Casey Beecham Blair, FNP

  • Family Medicine Physician
  • Lexington, TN
National Provider Identifier
1689326092
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31128 Issued in TN
Practice address
10777 Highway 412 W
Lexington, TN 38351-6283
Phone
(731) 968-5558
Fax
(731) 968-5567
NPI assigned
Jan 26, 2022
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31128 TN Primary

Addresses

Primary practice location

10777 Highway 412 W
Lexington, TN 38351-6283

Mailing address

10777 Highway 412 W
Lexington, TN 38351-6283
Phone (731) 968-5558

Other practice location 1

19 Security Dr
Jackson, TN 38305-3626
Phone (731) 664-9040

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
31128TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lentz Pediatrics, PLC CurrentSince Feb 1, 2022 Accepting new patients

Locations

19 Security Dr
Jackson, TN 38305
Phone (731) 256-8300

10777 Highway 412 W
Lexington, TN 38351
Phone (731) 968-5558

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1689326092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10777 HIGHWAY 412 W",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383516283",
            "telephone_number": "731-968-5558",
            "fax_number": "731-968-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 HIGHWAY 412 W",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383516283",
            "telephone_number": "731-968-5558",
            "fax_number": "731-968-5567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Security Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383053626",
            "country_code": "US",
            "telephone_number": "731-664-9040",
            "fax_number": "731-664-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "CASEY",
        "middle_name": "BEECHAM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "31128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.