STEWART R. BEASLEY JR. PH.D. LLC (NPI# 1689823973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689823973 |
| Entity Type | Organization |
| Organization Name | STEWART R. BEASLEY JR. PH.D. LLC |
| Practice Address |
1366 E 15th St Edmond OK 73013-5029 |
| Practice Telephone | 4053414313 |
| Practice Fax Number | 4053404567 |
| Mailing Telephone | 4053414313 |
| Mailing Fax Number | 4053404567 |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |
| Authorized Official Name | DR. STEWART R BEASLEY JR. (MANAGING MEMBER) |
| Authorized Official Telephone | 4053414313 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
199 | OK | Behavioral Health & Social Service Providers |
| Street Address |
1366 E 15TH ST |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-5029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396084968 | Alice Janine Wellington | Psychologist | 1900 Sleepy Hollow Rd, Edmond, OK 73034-7431 | 2013-02-02 |
| 1750664397 | Jessica Lee Plumley | Psychologist | 1300 E 9th St Ste 5, Edmond, OK 73034-5760 | 2011-09-20 |
| 1356622260 | Amanda Lower Burke | Psychologist | 1733 W 33rd St Ste 120, Edmond, OK 73013-3866 | 2011-09-06 |
| 1972733715 | Joy Lyn Kelley | Psychologist | 17508 Zinc, Edmond, OK 73012-7016 | 2009-07-14 |
| 1003074741 | Caleb Wayne Lack | Psychologist | 7413 Oak Ave, Edmond, OK 73034-9058 | 2008-05-29 |
| 1912176181 | Hannah Swallow | Psychologist | 920 S Boulevard St, Suite 103, Edmond, OK 73034-4731 | 2008-02-21 |
| 1154453439 | Gary A France | Psychologist | 11 Burton Pl, Edmond, OK 73013-4443 | 2007-03-12 |
| 1689702540 | Gricelda Fragoso | Psychologist | 1985 W 33rd St, Suite 110, Edmond, OK 73013-3875 | 2007-03-01 |
| 1689739344 | Randy Lynn Cochran | Psychologist | 2801 E Memorial Rd, Suite 102, Edmond, OK 73013-6474 | 2006-12-23 |
| 1568538429 | Tresa Roebuck Spencer | Psychologist | 1317 Bay Bridge Ct, Edmond, OK 73034-7076 | 2006-11-24 |
| Find all providers in EDMOND | ||||
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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.