DR. JACQUES DAVID BEVERIDGE M.D. NPI 1023283843

NPI Information

NPI: 1023283843
Provider Name: DR. JACQUES DAVID BEVERIDGE, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3952 PARKVIEW DR
CHEYENNE, WY
ZIP 82001
Phone: (307) 637-7700
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DR. Jacques David Beveridge, M.D. is a specialist in Cheyenne, WY with 29 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Jacques David Beveridge, M.D. NPI is 1023283843. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

3952 PARKVIEW DR
CHEYENNE, WY
ZIP 82001-102
Phone: (307) 637-7700
Fax: (307) 637-5672

The NPI 1023283843 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/23/2008 and was last updated on 12/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		6275A	WYOMING	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G94951	MEDICARE UPIN
2	W22005	OTHER	WYOMING	MEDICARE PTAN
3	114992000	MEDICAID	WYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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