NPIMap

Organization Active NPI

Beaver Medical Group, L.P.

  • Durable Medical Equipment & Medical Supplies
  • Redlands, CA
National Provider Identifier
1831434059
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BEAVER MEDICAL GROUP, L.P.
Practice address
245 Terracina Blvd.
Ste. 209
Redlands, CA 92373-4865
Phone
(909) 793-3311
Fax
(909) 307-6567
NPI assigned
Nov 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Dr. Charles Payton, M.D.
Title
Vice President/Chief Medical Office
Phone
(909) 478-5162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

245 Terracina Blvd.
Ste. 209
Redlands, CA 92373-4865

Mailing address

PO Box 2200
Redlands, CA 92373-0722
Phone (909) 335-4148

National Provider Directory

National Provider Directory
Tax ID family
Redlands Ucc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

245 Terracina Blvd
Ste 209
Redlands, CA 92373
Phone (909) 792-9737

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1831434059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730722",
            "telephone_number": "909-335-4148",
            "fax_number": "909-793-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 TERRACINA BLVD.",
            "address_2": "STE. 209",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734865",
            "telephone_number": "909-793-3311",
            "fax_number": "909-307-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER MEDICAL GROUP, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "PAYTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "VICE PRESIDENT/CHIEF MEDICAL OFFICE",
        "authorized_official_telephone_number": "909-478-5162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.