Individual provider Active NPI

Vera Ann Beadle, NP-C, PHMNP-BC

  • Family Nurse Practitioner
  • Devils Lake, ND
National Provider Identifier
1811078298
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R46932 Issued in ND
Practice address
200 Highway 2 W
Devils Lake, ND 58301-3532
Phone
(701) 665-2200
Fax
(701) 665-2300
NPI assigned
Oct 18, 2006
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704201918 MI
General Practice Registered Nurse 163WG0000X 128553 CO
Family Nurse Practitioner 363LF0000X 4704201918 MI
Family Nurse Practitioner 363LF0000X R46932 ND Primary

Addresses

Primary practice location

200 Highway 2 W
Devils Lake, ND 58301-3532

Mailing address

200 Highway 2 W
Devils Lake, ND 58301-3532
Phone (701) 665-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213001180 ND Practitioner - Nurse Practitioner 1254659543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Region Human Service CenterGroup PAC ID 8426941436, 16 clinicians

Practice addresses (Care Compare)

200 Hwy 2 W
Devils Lake, ND 58301-3532
Phone (701) 665-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
128553COMDGeneral Practice Registered Nurse
4704201918MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Behavioral Health Clinic CurrentSince Jan 4, 2019 Accepting new patients

Locations

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

200 Highway 2 W
Devils Lake, ND 58301
Phone (701) 665-2200

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1811078298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGHWAY 2 W",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013532",
            "telephone_number": "701-665-2200",
            "fax_number": "701-665-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGHWAY 2 W",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013532",
            "telephone_number": "701-665-2200",
            "fax_number": "701-665-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEADLE",
        "first_name": "VERA",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "NP-C, PHMNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704201918",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CO",
            "license": "128553",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704201918",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R46932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

Verify at the official NPI Registry.