Individual provider Active NPI

Evelyn J. Beaman, AGNP

  • Adult Health Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1770369555
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95026920 Issued in CA
Practice address
71949 Highway 111 Ste 300
Rancho Mirage, CA 92270-4826
Phone
(760) 568-2211
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95026920 CA Primary

Addresses

Primary practice location

71949 Highway 111 Ste 300
Rancho Mirage, CA 92270-4826

Mailing address

PO Box 221
Fawnskin, CA 92333-0221
Phone (951) 236-6245

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

LicenseStateTypeSpecialty
95026920CAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1770369555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221",
            "city": "FAWNSKIN",
            "state": "CA",
            "postal_code": "923330221",
            "telephone_number": "951-236-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71949 HIGHWAY 111 STE 300",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704826",
            "telephone_number": "760-568-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAMAN",
        "first_name": "EVELYN",
        "middle_name": "J.",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95026920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.