DR. JOHN P BEAVERS (NPI# 1003066143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003066143 |
| Entity Type | Individual |
| Full Name | DR. JOHN P BEAVERS |
| Credential | NP |
| Practice Address |
5717 Oakland Dr Portage MI 49024-1116 |
| Practice Telephone | 2693234473 |
| Mailing Telephone | 2693234473 |
| Mailing Fax Number | 5172782784 |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2015-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 4704234332 | MI | Allopathic & Osteopathic Physicians |
| Y | 363L00000X | Nurse Practitioner | 4704234332 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1003066143 | 05 | |
| MI | BCBSM | 500C961050 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386615839 | John E Beavers | Family Medicine | 7530 Nw 23rd St, Bethany, OK 73008-4921 | 2006-01-31 |
| Street Address |
5717 OAKLAND DR |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-1116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871591628 | Jennifer Ellen Kenyon | Physical Therapist | 5717 Oakland Dr, Suite B, Portage, MI 49024-1116 | 2005-07-14 |
| 1316553381 | Shelby Elizabeth Hooley | Chiropractor | 5717 Oakland Dr, Portage, MI 49024-1116 | 2020-09-16 |
| 1801385240 | Angela Marie Brannen | Nurse Practitioner | 5717 Oakland Dr, Portage, MI 49024 | 2018-05-01 |
| 1568811065 | Joshua Kettlewell | Physical Therapist | 5717 Oakland Dr, Portage, MI 49024-1116 | 2016-06-06 |
| 1427418094 | Sarah Brady | Social Worker | 5717 Oakland Dr, Suite A, Portage, MI 49024-1116 | 2016-02-25 |
| 1558720615 | Maribeth Henry | Physical Therapist | 5717 Oakland Dr, Suite B, Portage, MI 49024-1116 | 2016-02-17 |
| 1770954703 | Vitality Healthcare PC | Nurse Practitioner | 5717 Oakland Dr, Ste A, Portage, MI 49024-1116 | 2015-10-16 |
| 1508269515 | Casey Bennett | Physical Therapist | 5717 Oakland Dr, Portage, MI 49024-1116 | 2014-10-03 |
| 1144632779 | Megan Bly | Physical Therapist | 5717 Oakland Dr, Suite B, Portage, MI 49024-1116 | 2014-06-02 |
| 1366881005 | Rehab Specialists, LLC | Physical Therapist | 5717 Oakland Dr, Suite B, Portage, MI 49024-1116 | 2013-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275627713 | Mary Sullivan | Nurse Practitioner | 8001 Angling Road, Portage, MI 49024 | 2006-10-02 |
| 1730151978 | Julie Ann Olechnowicz | Nurse Practitioner | 8075 Creekside Dr Ste 120, Portage, MI 49024-5390 | 2006-02-02 |
| 1255333860 | Bonita J O'reilly | Nurse Practitioner | 8191 Moorsbridge Rd Ste A, Portage, MI 49024-7417 | 2005-08-12 |
| 1164047015 | Stephanie Jo Holt | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-06-16 |
| 1174185771 | Michael David Mccallister | Nurse Practitioner | 3770 Glenkerry Ct, Portage, MI 49024-0700 | 2019-07-03 |
| 1144880881 | Christina M Kemple-wascher | Nurse Practitioner | 7775 Angling Rd, Portage, MI 49024-7427 | 2019-06-14 |
| 1669936498 | Krista S Nguyen | Nurse Practitioner | 3691 Willowcreek Rd, Portage, IN 46368-5076 | 2019-01-25 |
| 1861987257 | Christine M Whelley | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901 | 2018-06-27 |
| 1356851570 | Laura L Noonan | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2017-10-02 |
| 1336663053 | Lana K Bretz | Nurse Practitioner | 2725 Airview Blvd Ste 105, Portage, MI 49002-1804 | 2017-08-03 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.