CHARLES ANTHONY BEASLEY JR. (NPI# 1881158723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881158723 |
| Entity Type | Individual |
| Full Name | CHARLES ANTHONY BEASLEY JR. |
| Practice Address |
1660 Hotel Cir N Ste 101 San Diego CA 92108-2801 |
| Practice Telephone | 6194813840 |
| Mailing Telephone | 6194813840 |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356669337 | Charles Britton Beasley Jr. | Psychiatry & Neurology | 2401 Pennsylvania Ave Ste 1c44-45, Philadelphia, PA 19130-3010 | 2010-05-14 |
| 1730390873 | Charles Merritt Beasley Jr. | Psychiatry & Neurology | 8161 Beech Knls, Indianapolis, IN 46256-2107 | 2007-05-24 |
| 1043217656 | Charles R. Beasley | Internal Medicine | 395 W 27th St, Lumberton, NC 28358-3018 | 2005-06-29 |
| 1184794646 | Charles Britton Beasley | Otolaryngology | 701 Doctors Dr, Kinston, NC 28501-1584 | 2006-11-09 |
| Street Address |
1660 HOTEL CIR N STE 101 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-2801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952797540 | Katelyn Anne Brady | Nurse Practitioner | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2015-04-09 |
| 1205462983 | Ivonne Salcedo | Case Manager/Care Coordinator | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2020-03-13 |
| 1609437193 | Travis Ryan Otteson | Case Manager/Care Coordinator | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2019-06-25 |
| 1922669415 | Brittany Echols | Case Manager/Care Coordinator | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2019-06-25 |
| 1861053340 | Edith Cosio | Case Manager/Care Coordinator | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2019-06-25 |
| 1457820425 | Victoria Charles | Case Manager/Care Coordinator | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2018-11-19 |
| 1073015103 | Kevin Dickmann | Licensed Vocational Nurse | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2018-03-05 |
| 1497279533 | Madison Brokman | Case Manager/Care Coordinator | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2017-07-31 |
| 1366986572 | Hosanna Hwang Alto | Counselor | 1660 Hotel Cir N Ste 101, San Diego, CA 92108 | 2016-12-06 |
| 1578923488 | Jessica Hudson | Counselor | 1660 Hotel Cir N Ste 101, San Diego, CA 92108-2801 | 2016-03-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
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| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1770105439 | Timothy Mccloud | Case Manager/Care Coordinator | 6160 Mission Gorge Rd # 108, San Diego, CA 92120-3410 | 2020-05-15 |
| 1043846272 | Daniel Rafael Martinez | Case Manager/Care Coordinator | 8825 Aero Dr Ste 305, San Diego, CA 92123-2270 | 2020-03-19 |
| 1043844376 | Ariel A Anderson | Case Manager/Care Coordinator | 8501 Larkdale Ave, San Diego, CA 92123-2047 | 2020-02-25 |
| 1124664818 | Sarah Milan | Case Manager/Care Coordinator | 1846 30th St Apt A, San Diego, CA 92102-1145 | 2019-11-18 |
| 1750930814 | Christine Guianne Mupas Ramos | Case Manager/Care Coordinator | 1660 Hotel Cir N # 320, San Diego, CA 92108-2807 | 2019-09-10 |
| 1437708518 | Brendan Domingo Guerra | Case Manager/Care Coordinator | 5617 Vista San Juanico, San Diego, CA 92154-5672 | 2019-09-10 |
| 1457912982 | Kendra Crater | Case Manager/Care Coordinator | 3481 Kurtz St, San Diego, CA 92110-4430 | 2019-06-25 |
| 1790342319 | Ariella Beth Darlington | Case Manager/Care Coordinator | 3644 Princeton Ave, San Diego, CA 92117-5637 | 2019-05-20 |
| 1013572361 | Brandon Joel Jessie | Case Manager/Care Coordinator | 1250 Morena Blvd Bldg 2nd, San Diego, CA 92110-3815 | 2019-05-02 |
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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.