Clisto Beaty, MD, PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

CLISTO BEATY, MD, PC

Practice address

650 Addison Ave W
Twin Falls, ID 83301-5444

Phone

(801) 993-9526

Fax

(801) 733-5872

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Clisto D Beaty, MD

Title

President

Phone

(801) 993-9526

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811088826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 FORT UNION BLVD",
            "address_2": "#105",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216800",
            "telephone_number": "801-993-9526",
            "fax_number": "801-733-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ADDISON AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015444",
            "telephone_number": "801-993-9526",
            "fax_number": "801-733-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLISTO BEATY, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "CLISTO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-993-9526",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.