Active NPI
Paul H Bearmon, MD
- Internal Medicine Physician
- St Louis Park, MN
National Provider Identifier
1699752188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 27104
- Practice address
- 3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527 - Phone
- (952) 993-3512
- NPI assigned
- Dec 27, 2005
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27104 | MN | Primary |
Addresses
Primary practice location
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Mailing address
8170 33Rd Ave S
PO Box 1309 Mail Stop 21110Q
Minneapolis, MN 55425-4516
Phone (952) 993-3512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106573400 | Medicaid | MN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27104 | MN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1699752188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"address_2": "PO BOX 1309 MAIL STOP 21110Q",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "952-993-3512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3850 PARK NICOLLET BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162527",
"telephone_number": "952-993-3512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARMON",
"first_name": "PAUL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-27",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "27104",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106573400",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.