Alexander Beavers, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019030499 Issued in IL

Practice address

403 Locust St
Carrollton, IL 62016-1304

Phone

(217) 942-6964

NPI assigned

Oct 14, 2015

Last updated

Oct 14, 2015By 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 1

Addresses

Other names 1

• Dr. Alex Beavers Other name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1891166989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 LOCUST ST",
            "city": "CARROLLTON",
            "state": "IL",
            "postal_code": "620161304",
            "telephone_number": "217-942-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LOCUST ST",
            "city": "CARROLLTON",
            "state": "IL",
            "postal_code": "620161304",
            "telephone_number": "217-942-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "BEAVERS",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• All Hart Chiropractic Inc
• Applied Medical and Performance Solutions Inc
• Abby Leigh Baalman, D.P.T.
• R Scott Beavers, DDS
• Kyndal Brown
• Carrollton Cu School Dist 1
• Carrollton Family Dental
• Ellen Caroline Christensen, AUD

• General Practice Dentistry in Carrollton, IL
• Providers in Carrollton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.

Verify at the official NPI Registry.