Active NPI
Fallon Beyer, PA-C
- Physician Assistant
- Clearwater, FL
National Provider Identifier
1730589797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9112312
- Practice address
- 1122 Druid Rd E
Clearwater, FL 33756 - Phone
- (274) 612-2827
- Fax
- (727) 443-6170
- NPI assigned
- Aug 27, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9112312 | FL | Primary |
Addresses
Primary practice location
1122 Druid Rd E
Clearwater, FL 33756
Mailing address
15051 S Tamiami TRL Ste 203
Fort Myers, FL 33908-5182
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9112312 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcoast Physicians Group, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Fairhaven, MA
- NPI 1336137629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1730589797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15051 S TAMIAMI TRL STE 203",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339085182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1122 DRUID RD E",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "33756",
"telephone_number": "274-612-2827",
"fax_number": "727-443-6170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEYER",
"first_name": "FALLON",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-27",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9112312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.