Justine Lyn Beaman, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.020473 Issued in IL

Practice address

2222 E State St Ste 209
Rockford, IL 61104-1572

Phone

(815) 988-8500

Fax

(815) 977-5956

NPI assigned

Oct 17, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Beam Biomark Health, PLLC

  • Health Service Clinic/Center
  • Oregon, IL
  • NPI 1285581702
  NPD Authorized official

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1780227124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E STATE ST STE 209",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611041572",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E STATE ST STE 209",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611041572",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Perryville Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611148011",
            "country_code": "US",
            "telephone_number": "815-971-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAMAN",
        "first_name": "JUSTINE",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041390906",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Bauman, ATC
• Susan J Baumgarth-Williams, COTA
• Ashley Baylor, LCPC
• Beacon of Enlightenment
• Kathryn V Beam, AUD
• Stephen Douglas Beaman, LCSW
• Brigid Bean, FNP-C
• Brian J Bear, MD
• Cynthia Ann Bear, PA
• Amanda M Beard, PT, DPT

• Family Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.

Verify at the official NPI Registry.