Staci Beasley

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Practice address

1301 York Rd Ste 800
Lutherville, MD 21093-6011

Phone

(800) 410-9508

NPI assigned

Oct 17, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Distinctive Diagnostics Laboratory

  • Clinical Medical Laboratory
  • Lutherville, MD
  • NPI 1043936297
  NPD Authorized official

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1891411229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E JOPPA RD APT 976",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212863166",
            "telephone_number": "717-881-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 YORK RD STE 800",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936011",
            "telephone_number": "800-410-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "STACI",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@distinctivediagnosticslaboratory.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf",
            "address_1": "1301 York Rd Ste 800",
            "city": "Lutherville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210936011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gary Baziz, O.D.
• Bruce Edmund Beacham, MD
• Katelyn Beam
• Mary F Bean, D.D.S.
• Ana M. Beard, P.A.-C
• Mary Elizabeth Beck, PA
• Daniel Becker, MD
• Marshall Stephen Bedine, M.D.
• Danielle Belinski, RD, LDN
• Peter Belitsos, M.D.

• Clinical Medical Laboratory in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.