Breck Markham Beasley, DC
Individual provider Active NPI Chiropractor · Covington, TN
NPI 1861528481 · NPPES record last updated Aug 13, 2015
Key facts
- NPI
- 1861528481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC0000001285 (TN)
- Practice address
- 210 W Pleasant Ave
Covington, TN 38019-2538 - Phone
- (901) 475-1100
- Fax
- (901) 475-1105
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
210 W Pleasant Ave
Covington, TN 38019-2538
Phone (901) 475-1100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080703000260 | TN | Practitioner - Chiropractic | 6406853662 | Practice locations: Covington, TN |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC0000001285 | TN | MD | Chiropractor |
| 1285 | TN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renew Medical Center LLC | Current |
Accepting new patients | |
| Tipton County Integrated Medicine | Current |
Accepting new patients | |
| Healthfirst 003 LLC | Chiropractor | Past |
Accepting new patients |
| Campbell Family Chiropractic LLC | Chiropractor | Past |
Accepting new patients |
| Link Chiropractic LLC | Chiropractor | Past |
Accepting new patients |
Locations
210 W Pleasant Ave
Covington, TN 38019
Phone (901) 475-1100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC0000001285 | TN | Yes |
Addresses
Primary practice location
210 W Pleasant Ave
Covington, TN 38019-2538
Mailing address
210 W Pleasant Ave
Covington, TN 38019-2538
Phone (901) 475-1100
Other providers in Covington, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.