NPIMap

Individual provider Active NPI

Evelyn Ntube Beal, MD

  • Obstetrics & Gynecology Physician
  • Fayetteville, NC
National Provider Identifier
1831151034
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
200000354 Issued in NC
Practice address
3363 Village Dr.
Suite 200
Fayetteville, NC 28304-4508
Phone
(910) 486-7006
Fax
(910) 222-0401
NPI assigned
Apr 4, 2006
Last updated
Apr 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 200000354 NC Primary

Addresses

Primary practice location

3363 Village Dr.
Suite 200
Fayetteville, NC 28304-4508

Mailing address

3363 Village Dr.
Suite 200
Fayetteville, NC 28304-4508
Phone (910) 486-7006

Other identifiers 2

IdentifierTypeStateIssuer
12628OtherNCBCBS
8912686MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120326000790 NC Practitioner - Obstetrics/Gynecology 6103890686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Cincinnati College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1367 Walter Reed Rd
Fayetteville, NC 28304-8066
Phone (910) 486-7006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200000354NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sandhills Womancare PA Obstetrics & Gynecology CurrentSince Feb 2, 2002 Accepting new patients

Locations

1367 Walter Reed Rd
Ste 101
Fayetteville, NC 28304
Phone (910) 486-7006

2125 Valleygate Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 323-1322

3363 Village Dr
Ste 200
Fayetteville, NC 28304
Phone (910) 486-7006

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1831151034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3363 VILLAGE DR.",
            "address_2": "SUITE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044508",
            "telephone_number": "910-486-7006",
            "fax_number": "910-222-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 VILLAGE DR.",
            "address_2": "SUITE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044508",
            "telephone_number": "910-486-7006",
            "fax_number": "910-222-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAL",
        "first_name": "EVELYN",
        "middle_name": "NTUBE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200000354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12628",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912686",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.