Robert Bishop Beedles Jr., IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

3380 Sturtevant St
BLDG 57 Second Floor
San Diego, CA 92136

Phone

(619) 887-9149

NPI assigned

Jan 17, 2012

Last updated

Jan 17, 2012By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1932470374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 STURTEVANT ST",
            "address_2": "BLDG 57 SECOND FLOOR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 STURTEVANT ST",
            "address_2": "BLDG 57 SECOND FLOOR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92136",
            "telephone_number": "619-887-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEDLES",
        "first_name": "ROBERT",
        "middle_name": "BISHOP",
        "name_suffix": "Jr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor James Beebout
• Jillian Beecher
• Matthew Beecher
• Michael J. Beecher, MD
• Paula Lynn Beede, MFT
• Kelsey Beehler
• Donald Byron Beeler Jr., NP
• Richard H Beeman, PA
• Kandice Renee Beenken, D.O.
• Adam G Beer, LMFT

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.