Active NPI
Jody Germaine Beaudoin, AGNP
- Adult Health Nurse Practitioner
- Elmira, NY
National Provider Identifier
1881163897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F308953-1
- Practice address
- 100 Washington St
Elmira, NY 14901-2849 - Phone
- (607) 737-4700
- Fax
- (607) 737-9080
- NPI assigned
- Nov 19, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F308953-1 | NY | Primary |
Addresses
Primary practice location
100 Washington St
Elmira, NY 14901-2849
Mailing address
1065 Sugar Hill Rd
Beaver Dams, NY 14812-9741
Phone (607) 684-0050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200207000987 | NY | Order and Referring Only - Nurse Practitioner | 0941636070 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F308953-1 | NY | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542585600000",
"number": "1881163897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 SUGAR HILL RD",
"city": "BEAVER DAMS",
"state": "NY",
"postal_code": "148129741",
"telephone_number": "607-684-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WASHINGTON ST",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149012849",
"telephone_number": "607-737-4700",
"fax_number": "607-737-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUDOIN",
"first_name": "JODY",
"middle_name": "GERMAINE",
"name_prefix": "Ms.",
"credential": "AGNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-19",
"last_updated": "2018-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F308953-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmira, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.