Holley Elizabeth Beam, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

69761 Issued in GA

Practice address

148 Clinic Ave
Carrollton, GA 30117

Phone

(770) 838-8640

Fax

(770) 838-8650

NPI assigned

May 12, 2010

Last updated

Jul 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Holley Elizabeth Jeter Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787

  Pediatrics

  Medicare reassignment NPD
• TMC Children's Healthcare of West Georgia

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1518972348
  NPD (past)
• Pediatrix Medical Group of Georgia, P.C.

  dba Pediatrix Medical Group of Central Georgia

  • Neonatal-Perinatal Medicine Physician
  • Sunrise, FL
  • NPI 1295827574
  NPD (past)
• Pediatrix Medical Group of Georgia, P.C.

  dba Atlanta Maternal-Fetal Medicine an affiliate of Obstetrix Medical Grou

  • Maternal & Fetal Medicine Physician
  • Sunrise, FL
  • NPI 1972695260
  NPD (past)

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1972821148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8640",
            "fax_number": "770-838-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-838-8640",
            "fax_number": "770-838-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAM",
        "first_name": "HOLLEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "69761",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "69761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLEY",
            "last_name": "JETER",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caroline H Barrett, RD
• Donya J. Bartlett, APRN BC
• Andrew M Bass, ATC
• Brittany Bates
• Tabe Battle, NP-C
• Adreana Beaumont
• Amber Nicole Bedley, RN, FNP
• William Edwin Behm, M.D.
• Trishawna Bell
• Scott Benefield

• Pediatrics Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.