Jacob Cody Beach (NPI# 1497169197, PAC ID# 8224370739) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1497169197 |
| PAC ID by PECOS | 8224370739 |
| Professional Enrollment ID | I20190502002969 |
| Full Name | Jacob Cody Beach |
| Organization Legal Name | DOMINION HEALTH MEDICAL ASSOC |
| Address |
946 N Main St Chase City VA 23924-1139 |
| Phone Number | 4343725141 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1254311558 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490013 | SENTARA HALIFAX REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 946 N Main St, Chase City, VA 23924-1139 | 4343725141 | DOMINION HEALTH MEDICAL ASSOC |
| 115 College St, Clarksville, VA 23927-9125 | 4343745344 | DOMINION HEALTH MEDICAL ASSOC |
| Organization Legal Name | DOMINION HEALTH MEDICAL ASSOC |
| Physicians | 49 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jean M Minier | Nurse Practitioner | Dominion Health Medical Assoc | 15210 L P Bailey Memorial Hwy, Nathalie, VA 24577-3304 |
| Keysha D Ahmad-winborne | Nurse Practitioner | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Whitney H Wilborn | Nurse Practitioner | Dominion Health Medical Assoc | 101 Aubreys Loop, South Boston, VA 24592-5054 |
| Gwendolyn L Riddick | Obstetrics/gynecology | Dominion Health Medical Assoc | 115 College St, Clarksville, VA 23927-9125 |
| Michelle B Gibson | Nurse Practitioner | Dominion Health Medical Assoc | 2232 Wilborn Ave, South Boston, VA 24592-1662 |
| Michael K Kyles | Orthopedic Surgery | Dominion Health Medical Assoc | 422 Hamilton Blvd, South Boston, VA 24592-5200 |
| Lovetta Pugh | General Surgery | Dominion Health Medical Assoc | 2212 Wilborn Ave, South Boston, VA 24592-1630 |
| Michelle M Grant | Certified Registered Nurse Anesthetist (crna) | Dominion Health Medical Assoc | 2204 Wilborn Ave, South Boston, VA 24592-1645 |
| Sameer S Alrefai | General Surgery | Dominion Health Medical Assoc | 2204 Wilborn Ave, South Boston, VA 24592-1645 |
| Fernando Gomez-rivera | Otolaryngology | Dominion Health Medical Assoc | 2232 Wilborn Ave, South Boston, VA 24592-1662 |
| Street Address |
946 N MAIN ST |
| City | CHASE CITY |
| State | VA |
| Zip | 23924-1139 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Keysha D Ahmad-winborne | Nurse Practitioner | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Vivia B Whitfield | Nurse Practitioner | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Henry Thurston Browning | Family Medicine | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Randall Suslick | Family Medicine | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Rachael A Burton | Family Medicine | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Jessica D Ruff | Nurse Practitioner | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Alyssa N Milam | Nurse Practitioner | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jagdeep Singh | Physical Therapy | 503 N Main St, Chase City, VA 23924-1407 | |
| Kirk R Hasenmueller | Family Medicine | Cmh Physician Services, LLC | 200 E 5th St, Chase City, VA 23924-1456 |
| Stacy Rae Davis | Nurse Practitioner | Cmh Physician Services, LLC | 200 E 5th St, Chase City, VA 23924-1456 |
| City | CHASE CITY |
| Zip Code | 23924 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CHASE CITY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jacob Cody Beach.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.