Broadus Monroe Beeson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0000014671 Issued in TN

Practice address

240 Medical Park Blvd
Suite 3800
Bristol, TN 37620-7346

Phone

(423) 990-2466

Fax

(423) 990-2407

NPI assigned

Aug 8, 2006

Last updated

Sep 16, 2009By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1992715742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2093",
            "fax_number": "423-857-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEDICAL PARK BLVD",
            "address_2": "SUITE 3800",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207346",
            "telephone_number": "423-990-2466",
            "fax_number": "423-990-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEESON",
        "first_name": "BROADUS",
        "middle_name": "MONROE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000014671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513307",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992715742",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany LD Bays, MS, ATC, PA-C
• Madison Asher Bazyk, PT
• Braden Elizabeth Beckham, PT
• David C Beckner, MD
• Deborah Carroll Beeler, LPN
• Vinaya S Belagode, MD
• John Michael Bell, MD
• Bellebrook Rd Healthcare LLC (Appalachian Highlands Health & Rehab Center)
• Jacob Lloyd Benfield, MD
• Philip Joel Benfield, MD

• Family Medicine Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.