Caleb Jordan Beattie, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

3399 Strauss Ave Ste 219
Indian Head, MD 20640-5164

Phone

(904) 718-1179

NPI assigned

Jul 6, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1801467485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 STRAUSS AVE STE 219",
            "city": "INDIAN HEAD",
            "state": "MD",
            "postal_code": "206405164",
            "telephone_number": "904-718-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 STRAUSS AVE STE 219",
            "city": "INDIAN HEAD",
            "state": "MD",
            "postal_code": "206405164",
            "telephone_number": "904-718-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTIE",
        "first_name": "CALEB",
        "middle_name": "JORDAN",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Quiana Allen
• Breanna Anderson
• Jenelle Robinson Anthony, PSY.D.
• Danella Armstrong, LPC, NCC
• Alexandra Bennett, CCC-SLP
• Monica L Bilik, PA-C
• Alexander Blake
• Augustina O Boadu
• Branch Medical Clinic Indian Head

• All providers in Indian Head, MD
• Independent Duty Corpsman in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.