Alvin Ray Beezley Jr., D. O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15421 Issued in MS

Practice address

9692 Wolf Road
Caledonia, MS 39740

Phone

(662) 356-0324

Fax

(662) 356-0322

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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.

• Jrco, LLC

  • Specialist
  • Caledonia, MS
  • NPI 1184056285
  NPD (past) Authorized official
• Pine Belt Anesthesia, LLC

  • Anesthesiology Physician
  • Hattiesburg, MS
  • NPI 1831534783
  NPD (past)
• QHG of Hattiesburg Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Hattiesburg, MS
  • NPI 1326032400
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

• Dr. Alvin Ray Beezley Jr. Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2023.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922056159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9692 WOLFE RD",
            "city": "CALEDONIA",
            "state": "MS",
            "postal_code": "397409223",
            "telephone_number": "662-356-0324",
            "fax_number": "662-356-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9692 WOLF ROAD",
            "city": "CALEDONIA",
            "state": "MS",
            "postal_code": "39740",
            "telephone_number": "662-356-0324",
            "fax_number": "662-356-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEZLEY",
        "first_name": "ALVIN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15421",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "15421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07757360",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "512I110141",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALVIN",
            "last_name": "BEEZLEY",
            "middle_name": "RAY",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blissful Moments Doula & Birth Services, LLC.
• Caledonia Community Clinic, LLC
• Lee Vester Calvert Jr., FNP-C
• Clark Drug Company, LLC
• Robert Justin Clark, PHARMD

• All providers in Caledonia, MS
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.