BEAVER MEDICAL, LLC (NPI# 1770570202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770570202 |
| Entity Type | Organization |
| Organization Name | BEAVER MEDICAL, LLC |
| Other Organization Name | BEAVER MEDICAL CLINIC |
| Practice Address |
1059 N 100 W Beaver UT 84713-1690 |
| Mailing Address |
Po Box 1690 Beaver UT 84713-1690 |
| Practice Telephone | 4354387280 |
| Practice Fax Number | 4354387210 |
| Mailing Telephone | 4354387280 |
| Mailing Fax Number | 4354387210 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2016-11-16 |
| Authorized Official Name | MRS. JULIE CHRISTENSEN (OFFICE MANAGER) |
| Authorized Official Telephone | 4354387280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
47255720160 | UT | Ambulatory Health Care Facilities |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | PALMETTO RAILROAD MEDICARE | CG2421 | 01 |
| Other Name | Type Code |
|---|---|
| Beaver Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336136969 | Beaver Medical, LLC | Clinic/Center | 850 N Main, Milford, UT 84751-0640 | 2005-09-29 |
| 1558358184 | Beaver Medical, LLC | Clinic/Center | 450 East Clinic Way, Parowan, UT 84761-1690 | 2005-09-29 |
| Street Address |
1059 N 100 W |
| City | BEAVER |
| State | UT |
| Zip Code | 84713-1690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841295938 | Kenneth Lynn Hussey | Physician Assistant | 1059 N 100 W, Beaver, UT 84713-1690 | 2005-06-16 |
| 1740750561 | Joan Yardley | Nurse Practitioner | 1059 N 100 W, Beaver, UT 84713-7758 | 2018-12-05 |
| 1811399116 | Reagan Fails | Physician Assistant | 1059 N 100 W, Beaver, UT 84713-1690 | 2014-09-18 |
| 1568800209 | Rhett R Smith | Family Medicine | 1059 N 100 W, Beaver, UT 84713-1690 | 2013-06-04 |
| 1952605370 | Travis Hicks | Physician Assistant | 1059 N 100 W, Beaver, UT 84713-1690 | 2010-12-28 |
| 1972747269 | Lindsay Ann Cheney | Nurse Practitioner | 1059 N 100 W, Beaver, UT 84713-1690 | 2009-04-30 |
| 1518117167 | David Myntti | Physician Assistant | 1059 N 100 W, Beaver, UT 84713-1690 | 2008-09-19 |
| 1083755342 | Rebecca S Rasmusson | Nurse Practitioner | 1059 N 100 W, Beaver, UT 84713-1690 | 2007-02-09 |
| 1295817708 | Lance Clyde Smith | Family Medicine | 1059 N 100 W, Beaver, UT 84713-1690 | 2006-10-20 |
| 1962438895 | Wade Hollingshead | Nurse Practitioner | 1059 N 100 W, Beaver, UT 84713-1690 | 2006-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780086983 | E. Jones Legacy Care Homes | Assisted Living Facility | 380 N 500 W, Beaver, UT 84713 | 2014-09-18 |
| 1679823876 | H2rx | Pharmacy | 98 N Main Street #b, Beaver, UT 84713 | 2012-09-14 |
| 1699042176 | Shari Lyn Gillins | Case Manager/Care Coordinator | 75 West 1175 North, Beaver, UT 84713 | 2011-11-28 |
| 1558563650 | Doris Gale Cowan | Registered Nurse | 590 North 100 East, Beaver, UT 84713 | 2007-06-01 |
| 1942420229 | David S Howard | Dentist | 225 N Main, Beaver, UT 84713 | 2007-04-27 |
| 1487772315 | Delmont G. Myers | Dentist | 885 No, 50 E., Beaver, UT 84713 | 2007-03-27 |
| 1700928785 | Kathleen Hanley Rose | Social Worker | 75 W 1175 N, Beaver, UT 84713 | 2007-02-13 |
| 1679646319 | Gary W. Clark A Professional Corporation | Durable Medical Equipment & Medical Supplies | 55 N 400 E, Beaver, UT 84713 | 2006-11-17 |
| 1477666295 | Harold D Murdock | Dentist | 55 No 400 E, Beaver, UT 84713 | 2006-08-16 |
| 1114194909 | Kandance Muir | Case Manager/Care Coordinator | 75 W 1175 N, Beaver, UT 84713 | 2008-05-12 |
| Find all providers in zip 84713 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1700499183 | Grab Healthcare, LLC | Clinic/Center | 245 E 2150 N, Suite C, Layton, UT 84041 | 2020-08-26 |
| 1851917496 | Centre Health Group | Clinic/Center | 70 West Main, Suite B, American Fork, UT 84003 | 2020-06-19 |
| 1942821947 | First Choice Healthcare, LLC | Clinic/Center | 250 N American Way, Brigham City, UT 84302-2074 | 2020-04-30 |
| 1912526294 | Boyer Medical Solutions | Clinic/Center | 2322 N 2080 W, Lehi, UT 84043-4897 | 2020-04-16 |
| 1164066015 | Sterling Provider Group | Clinic/Center | 700 S Highway 91, Richmond, UT 84333-1209 | 2019-11-04 |
| 1760033443 | Careatc | Clinic/Center | 669 W 200 S, Salt Lake City, UT 84101-1014 | 2019-09-24 |
| 1174006605 | Bristol Palliative Care Services, L.L.C. | Clinic/Center | 3216 S Highland Dr Ste 100, Salt Lake City, UT 84106-4196 | 2018-09-11 |
| 1649790080 | Jupiter Medical II LLC | Clinic/Center | 7724 S 5600 W Ste 102, West Jordan, UT 84081-5415 | 2017-06-27 |
| 1932640752 | Indiemed LLC | Clinic/Center | 25 N 2000 W Ste 3, Hurricane, UT 84737-4115 | 2017-03-13 |
| 1649719063 | Sara Arrington, A.p.r.n., P.l.l.c | Clinic/Center | 3110 W 300 N Ste A, West Point, UT 84015-7481 | 2017-02-17 |
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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.