Individual provider Active NPI

Suzanne Obrien Beeson, PH.D

  • Psychologist
  • Anderson, IN
National Provider Identifier
1891711586
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20041045A Issued in IN
Practice address
1210 Medical Arts. Blvd.
Suite 208
Anderson, IN 46011
Phone
(765) 298-5353
Fax
(765) 298-4988
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20041045A IN Primary

Addresses

Primary practice location

1210 Medical Arts. Blvd.
Suite 208
Anderson, IN 46011

Mailing address

1210 Medical Arts. Blvd.
Suite 208
Anderson, IN 46011
Phone (765) 298-5353

Other identifiers 1

IdentifierTypeStateIssuer
20041045AOtherINSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080516000174 IN Practitioner - Clinical Psychologist 5799868568 Practice locations: Anderson, IN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Indiana University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1210 Medical Arts Blvd
Suite 208
Anderson, IN 46011-3437
Phone (765) 298-5353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20041045AINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Psychiatric Clinic LLC PastSince Nov 1, 1999 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1891711586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 MEDICAL ARTS. BLVD.",
            "address_2": "SUITE 208",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "46011",
            "telephone_number": "765-298-5353",
            "fax_number": "765-298-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MEDICAL ARTS. BLVD.",
            "address_2": "SUITE 208",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "46011",
            "telephone_number": "765-298-5353",
            "fax_number": "765-298-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEESON",
        "first_name": "SUZANNE",
        "middle_name": "OBRIEN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041045A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20041045A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.