Individual provider Active NPI

Breck Markham Beasley, DC

  • Chiropractor
  • Covington, TN
National Provider Identifier
1861528481
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000001285 Issued in TN
Practice address
210 W Pleasant Ave
Covington, TN 38019-2538
Phone
(901) 475-1100
Fax
(901) 475-1105
NPI assigned
Feb 26, 2007
Last updated
Aug 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000001285 TN Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080703000260 TN Practitioner - Chiropractic 6406853662 Practice locations: Covington, TN

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0000001285TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tipton County Integrated Medicine CurrentSince Oct 1, 2016 Accepting new patients
Renew Medical Center LLC CurrentSince Apr 1, 2019 Accepting new patients
Campbell Family Chiropractic LLC Chiropractor PastSince Dec 3, 2007 Accepting new patients
Link Chiropractic LLC Chiropractor PastSince Apr 30, 2003 Accepting new patients
Healthfirst 003 LLC Chiropractor PastSince Apr 30, 2003 Accepting new patients

Locations

210 W Pleasant Ave
Covington, TN 38019
Phone (901) 475-1100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1861528481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W PLEASANT AVE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380192538",
            "telephone_number": "901-475-1100",
            "fax_number": "901-475-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W PLEASANT AVE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380192538",
            "telephone_number": "901-475-1100",
            "fax_number": "901-475-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "BRECK",
        "middle_name": "MARKHAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.