Beverly Ann Mantooth

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

117801 S 4163 Rd
Eufaula, OK 74432-6607

Phone

(918) 680-2270

NPI assigned

Jun 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1871117846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117801 S 4163 RD",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744326607",
            "telephone_number": "918-680-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117801 S 4163 RD",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744326607",
            "telephone_number": "918-680-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTOOTH",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maisie Lanham
• Michael Laramie
• Melissa Mae Lile, LCSW
• Coleen Logan, FNP-C
• Dallie Lovett, RN
• McAlester Regional Dialysis Center, LLC (Eufaula Dialysis Center)
• Danielle McGraw, LM, CPM
• Karissa Suzanne McIntosh
• Roley Dale McIntosh, DDS PC
• Stanley P McIntosh, D.D.S.

• Attendant Care Provider in Eufaula, OK
• Providers in Eufaula, OK by specialty
• Attendant Care Provider in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.