Active NPI
Stuart Beauchamp, DMD
- Periodontics
- Ormond Beach, FL
National Provider Identifier
1831550292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN23905
- Practice address
- 220 S Nova Rd
Ormond Beach, FL 32174-6117 - Phone
- (386) 672-9440
- NPI assigned
- Mar 14, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN23905 | FL | Primary |
Addresses
Primary practice location
220 S Nova Rd
Ormond Beach, FL 32174-6117
Mailing address
924 Hickman Rd
Unit C
Augusta, GA 30904-6720
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN23905 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1831550292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 HICKMAN RD",
"address_2": "UNIT C",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309046720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 S NOVA RD",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321746117",
"telephone_number": "386-672-9440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUCHAMP",
"first_name": "STUART",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-14",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN23905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.