NPIMap

Individual provider Active NPI

Grace S. Beaumont, MD

  • Family Medicine Physician
  • Saint James, MO
National Provider Identifier
1700935459
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
103254 Issued in MO
Practice address
107 W Eldon St
Saint James, MO 65559-1903
Phone
(573) 265-1818
Fax
(573) 265-1810
NPI assigned
Jan 10, 2007
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 103254 MO Primary

Addresses

Primary practice location

107 W Eldon St
Saint James, MO 65559-1903

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other practice location 1

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 767-2273

Other practice location 2

11863 State Highway 13
Kimberling City, MO 65686-8362
Phone (417) 739-1995

Other practice location 3

1059 Barton Dr
Fordland, MO 65652-7350
Phone (417) 767-2273

Other identifiers 1

IdentifierTypeStateIssuer
208472100MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000628 MO Practitioner - Family Practice 0547249906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fordland Clinic, Inc.Group PAC ID 5597794552, 10 clinicians

Practice addresses (Care Compare)

11863 State Hwy 13
Suite 1
Kimberling City, MO 65686-8372
Phone 41776722732022

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fordland Clinic, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Mercy Hospital Lebanon Current Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jul 1, 2004 Accepting new patients
Fordland Clinic, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1059 Barton Dr
Fordland, MO 65652
Phone (417) 767-2100

11863 State Highway 13
Ste 1
Kimberling City, MO 65686
Phone (417) 739-2520

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400

1300 E Bradford Pkwy
Bldg B
Springfield, MO 65804
Phone (417) 269-5400

Interoperability endpoints

  • Direct secure messaging: gbeaumont@11ef84f8.micromddirect.com
  • Direct secure messaging: gbeaumont1162@directb.mercy.net

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1700935459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W ELDON ST",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655591903",
            "telephone_number": "573-265-1818",
            "fax_number": "573-265-1810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Bradford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658044264",
            "country_code": "US",
            "telephone_number": "417-767-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11863 State Highway 13",
            "address_purpose": "LOCATION",
            "city": "Kimberling City",
            "state": "MO",
            "postal_code": "656868362",
            "country_code": "US",
            "telephone_number": "417-739-1995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1059 Barton Dr",
            "address_purpose": "LOCATION",
            "city": "Fordland",
            "state": "MO",
            "postal_code": "656527350",
            "country_code": "US",
            "telephone_number": "417-767-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUMONT",
        "first_name": "GRACE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "103254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208472100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, MO

Sources for this page

Verify at the official NPI Registry.