Individual provider Active NPI

Andrew A Beaulieu, LMSW

  • Social Worker
  • Elmendorf AFB, AK
National Provider Identifier
1801036603
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
869 Issued in AK
Practice address
5955 Zeamer Avenue
3MDG
Elmendorf AFB, AK 99506
Phone
(907) 580-3205
NPI assigned
Mar 6, 2009
Last updated
Mar 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 869 AK Primary

Addresses

Primary practice location

5955 Zeamer Avenue
3MDG
Elmendorf AFB, AK 99506

Mailing address

5955 Zeamer Avenue
3MDG
Elmendorf AFB, AK 99506
Phone (907) 580-3205

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
869AKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1801036603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVENUE",
            "address_2": "3MDG",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVENUE",
            "address_2": "3MDG",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "ANDREW",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AK",
            "license": "869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmendorf AFB, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.