Active NPI
Trevor Scott Beahm
- Student in an Organized Health Care Education/Training Program
- State College, PA
National Provider Identifier
1730534819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 30596330
- Practice address
- 406 Candlewood Dr
State College, PA 16803-1248 - Phone
- (814) 404-8967
- NPI assigned
- Apr 26, 2016
- Last updated
- Apr 26, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 30596330 | PA | Primary |
Addresses
Primary practice location
406 Candlewood Dr
State College, PA 16803-1248
Mailing address
406 Candlewood Dr
State College, PA 16803-1248
Phone (814) 404-8967
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30596330 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461628800000",
"number": "1730534819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 CANDLEWOOD DR",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168031248",
"telephone_number": "814-404-8967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 CANDLEWOOD DR",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168031248",
"telephone_number": "814-404-8967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAHM",
"first_name": "TREVOR",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-26",
"last_updated": "2016-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "30596330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
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- BCC State College Operations, LLC (Elmcroft of State College)
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- Julia Rebecca Beard
- Robert William Beccue, D.C.
- Beck Psychotherapy, LLC
- Christy Beck, M.ED., NCC, L.P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.