Individual provider Active NPI

Bethany Besand

  • Clinical Social Worker
  • O'Fallon, MO
National Provider Identifier
1699250043
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2010006754 Issued in MO
Practice address
7425 Heathermoor LN
O Fallon, MO 63368-7232
Phone
(636) 233-1261
NPI assigned
Oct 2, 2018
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2010006754 MO Primary

Addresses

Primary practice location

7425 Heathermoor LN
O Fallon, MO 63368-7232

Mailing address

7425 Heathermoor LN
O Fallon, MO 63368-7232
Phone (636) 233-1261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331000429 CA Practitioner - Clinical Social Worker 7911482757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

493 Boardwalk Springs PL
O Fallon, MO 63368-3994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010006754MOMDClinical Social Worker

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1699250043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 HEATHERMOOR LN",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687232",
            "telephone_number": "636-233-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 HEATHERMOOR LN",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687232",
            "telephone_number": "636-233-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESAND",
        "first_name": "BETHANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010006754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.