Individual provider Active NPI

John Michael Beckham, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1770074023
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T0422 Issued in TX
Practice address
3600 Gaston Ave Wadley Tower Suite 550
Dallas, TX 75246
Phone
(214) 821-1177
Fax
(214) 821-1193
NPI assigned
May 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T0422 TX Primary

Addresses

Primary practice location

3600 Gaston Ave Wadley Tower Suite 550
Dallas, TX 75246

Mailing address

3600 Gaston Ave Wadley Tower Suite 550
Dallas, TX 75246
Phone (214) 821-1177

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbeckham837050@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210923003234 TX Practitioner - Internal Medicine 6406104785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Baylor College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3600 Gaston Ave
Suite 550
Dallas, TX 75246-1905
Phone (972) 451-0219

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T0422TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Sep 13, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 13, 2021 Accepting new patients
Baylor University Medical Center Past Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1770074023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE WADLEY TOWER SUITE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE WADLEY TOWER SUITE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKHAM",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T0422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbeckham837050@direct.sw.org",
            "affiliation": "N",
            "address_1": "3600 Gaston Ave Wadley Tower Suite 550",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.