Active NPI
Beverly Bracken, DO
- Psychiatry Physician
- Worthington, OH
National Provider Identifier
1811086408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 34001807
- Practice address
- 445 E Dublin Granville Rd
BLDG N
Worthington, OH 43085-3192 - Phone
- (614) 293-9550
- Fax
- (614) 293-9549
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 34001807 | OH | Primary |
Addresses
Primary practice location
445 E Dublin Granville Rd
BLDG N
Worthington, OH 43085-3192
Mailing address
445 E Dublin Granville Rd
BLDG N
Worthington, OH 43085-3192
Phone (614) 293-9550
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34001807 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emily Program PC | Past | Accepting new patients | |
| Center for Eating Disorders & Psychotherapy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Registered Dietitian
- Worthington, OH
- NPI 1871910109
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Columbus, OH
- NPI 1669444329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811086408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 E DUBLIN GRANVILLE RD",
"address_2": "BLDG N",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430853192",
"telephone_number": "614-293-9550",
"fax_number": "614-293-9549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 E DUBLIN GRANVILLE RD",
"address_2": "BLDG N",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430853192",
"telephone_number": "614-293-9550",
"fax_number": "614-293-9549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACKEN",
"first_name": "BEVERLY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "34001807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.