Clarence Henry Beavers, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

39543 Issued in NC

Practice address

207 E Meadow Rd Ste 1
Eden, NC 27288-3469

Phone

(336) 627-3194

Fax

(336) 627-3208

NPI assigned

Jun 1, 2005

Last updated

Aug 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

West Virginia University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EICDCD/Endpoint/EICDCD

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.

• Beavers Dermatology & Skin Surgery, PLLC

  • Dermatology Physician
  • Eden, NC
  • NPI 1477842573
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1871595082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1693",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "287131693",
            "telephone_number": "336-967-0004",
            "fax_number": "828-538-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E MEADOW RD STE 1",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272883469",
            "telephone_number": "336-627-3194",
            "fax_number": "336-627-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "CLARENCE",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "39543",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871595082",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2154554D",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00935587",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Barney, MD
• Jarrett Barts
• Brad Lee Bauer, M.D.
• Be Your Best, Inc.
• Beavers Dermatology & Skin Surgery, PLLC
• Birds Song of North Carolina
• Ashya Black
• Annie Delores Blackwell, CRNA
• Body & Face LLC
• Alyssa Horton Boles, PA-C

• Dermatology Physician in Eden, NC
• Providers in Eden, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.