B J Beckerrn, RN

Primary specialty

Adult CompanionTaxonomy code 372600000X

License

39979100 Issued in WI

Practice address

6283 Riesch Rd
West Bend, WI 53095-9106

Phone

(262) 334-1021

Fax

(262) 334-0556

NPI assigned

Jan 16, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811048739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6283 RIESCH RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959106",
            "telephone_number": "262-334-1021",
            "fax_number": "262-334-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6283 RIESCH RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959106",
            "telephone_number": "262-334-1021",
            "fax_number": "262-334-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKERRN",
        "first_name": "B",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "WI",
            "license": "39979100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIOR AUTHROIZATION #",
            "identifier": "3095070",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kassandra Bauman, OTR/L
• Roxanne Lynn Baumann, PTA
• Vanessa Baumann, BSCJ, SAC-IT
• Mary Grace Baumgartner, LCSW
• Nickole Becker, LPC-IT
• Constance Bednar, OTR
• Dawn M. Bednarek, P.T.A.
• Jerold J Beerends, MD
• Rachel Beimborn, R.N.
• Kelly Marie Bell, LCSW

• All providers in West Bend, WI
• Adult Companion in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.