Nathan Keil Beavers, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

PEDO-377-04 Issued in MS

Practice address

312 Fountains Dr
Madison, MS 39110-6384

Phone

(601) 856-5313

Fax

(601) 856-5552

NPI assigned

Dec 20, 2006

Last updated

Oct 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nathan K. Beavers DMD PLLC

  dba Beavers Pediatric Dentistry

  • Pediatric Dentistry
  • Madison, MS
  • NPI 1003138967
  NPD

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1790849404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 FOUNTAINS DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106384",
            "telephone_number": "601-856-5313",
            "fax_number": "601-856-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 FOUNTAINS DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106384",
            "telephone_number": "601-856-5313",
            "fax_number": "601-856-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "NATHAN",
        "middle_name": "KEIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "PEDO-377-04",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08101262",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baptist PT - Madison
• Jasmine Barnes
• Vernita A Barton, CCC-SLP
• Erica Hutcheson Bass, M.D.
• Haleigh Hanna Bates, PA-C
• Belhaven Senior Care (The Madison Health and Rehab)
• Blake Stewart Bell, DMD
• Jericho Loree Bell, M.D.
• Patti Bell, FNP-BC
• Elizabeth Anne Bennett, PHARM.D.

• Pediatric Dentistry in Madison, MS
• Providers in Madison, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.