Active NPI
Clisto D Beaty, MD
- Anesthesiology Physician
- Payson, UT
National Provider Identifier
1891806162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 169252-1205
- Practice address
- 1000 E 100 N
Payson, UT 84651-1600 - Phone
- (800) 748-4868
- Fax
- (801) 733-5872
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 169252-1205 | UT | Primary |
| Anesthesiology Physician | 207L00000X | M-4600 | ID |
Addresses
Primary practice location
1000 E 100 N
Payson, UT 84651-1600
Mailing address
PO Box 311
Payson, UT 84651-0311
Phone (801) 423-1039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-4600 | ID | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891806162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 311",
"city": "PAYSON",
"state": "UT",
"postal_code": "846510311",
"telephone_number": "801-423-1039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E 100 N",
"city": "PAYSON",
"state": "UT",
"postal_code": "846511600",
"telephone_number": "800-748-4868",
"fax_number": "801-733-5872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATY",
"first_name": "CLISTO",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "169252-1205",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "M-4600",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Payson, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.