ETHEL S BEASLEY (NPI# 1154321354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154321354 |
| Entity Type | Individual |
| Full Name | ETHEL S BEASLEY |
| Credential | MD |
| Practice Address |
210 Hospital Cir Choctaw MS 39350-6781 |
| Practice Telephone | 6016562211 |
| Practice Fax Number | 6013896391 |
| Mailing Telephone | 6016562211 |
| Mailing Fax Number | 6013896391 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2014-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 12703 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | MEDICAID OF AL | 009974375 | 01 |
| MS | 00111151 | 05 | |
| BLUE CROSS OF AL | 73014344 | 01 |
| Street Address |
210 HOSPITAL CIR |
| City | CHOCTAW |
| State | MS |
| Zip Code | 39350-6781 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265999247 | Kimberly Lynn Eldridge | Nurse Practitioner | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2019-02-26 |
| 1508322421 | Tiah Rae York | Registered Nurse | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2019-02-15 |
| 1194280883 | Karen Louise Miller | Nurse Practitioner | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2019-02-06 |
| 1669957833 | Annette Marie Lewis | Social Worker | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2018-10-03 |
| 1124507223 | Lindsey E Wilson | Dietitian, Registered | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2018-08-09 |
| 1538648639 | Natalie A Byram | Dietitian, Registered | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2018-08-09 |
| 1982183083 | Allison Boatner | Dietitian, Registered | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2018-08-09 |
| 1255843033 | Shannon Victoria Johnson | Nurse Practitioner | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2017-11-01 |
| 1780105239 | Anna Clare Saxon | Dentist | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2017-07-05 |
| 1215462502 | Marjorie Britt | Pharmacist | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2017-04-25 |
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|---|---|---|---|---|
| 1548817133 | Airpark Family Dentistry | Dentist | 1060 Holland Avenue, Philadelphia, MS 39350 | 2019-08-20 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1144759580 | Mapp Home Care Services | In Home Supportive Care | 41 Eastover Dr, Philadelphia, MS 39350 | 2017-06-08 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1114339405 | Bernard Oneal | Adult Companion | 10090 Rd 0022, None, Philadelphia, MS 39350 | 2014-05-21 |
| 1417213323 | Region Ten Commision On Mental Health | Clinic/Center | 1011 Posey Avenue, Philadelphia, MS 39350 | 2012-04-04 |
| 1851427132 | Performance Therapy LLC | Physical Therapist | Performance Therapy, LLC, 921 W Beacon Street, Philadelphia, MS 39350 | 2007-02-23 |
| 1922161900 | Ernest Barton Cross | Audiologist | 1120 East Main Street, Suite 4, Philadelphia, MS 39350 | 2006-12-19 |
| 1649348129 | Augustus P Soriano | Family Medicine | 517 Center Avenue, Philadelphia, MS 39350 | 2006-12-01 |
| 1982777983 | Bill G Molpus | Dentist | 247 Byrd Ave, Philadelphia, MS 39350 | 2006-11-16 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| 1215556048 | Hannah Roberts Badon | Internal Medicine | 2450 Wild Valley Dr, Jackson, MS 39211-6224 | 2020-04-12 |
| 1649809476 | Rachel Horn Mullins | Internal Medicine | 5379 Fairway St, Jackson, MS 39211-4251 | 2020-04-03 |
| 1497391288 | Ahmad Abdali Haidar Md Pa | Internal Medicine | 200 Golf Course Dr, Carriere, MS 39426-9037 | 2019-11-27 |
| 1437711991 | Amanda L Wiltshire | Internal Medicine | 1300 Sunset Dr Ste A, Grenada, MS 38901-4081 | 2019-07-05 |
| 1447812540 | Waqaar Ahmed Arshad | Internal Medicine | 3226 Kendrick Rd Apt 14, Corinth, MS 38834-9207 | 2019-06-28 |
| 1023675048 | Fitvisits LLC | Internal Medicine | 731 S Pear Orchard Rd Ste 16, Ridgeland, MS 39157-4800 | 2019-05-24 |
| 1629542832 | Internal Medicine Primary Care Pa | Internal Medicine | 140 Daughdrill Sta, Flowood, MS 39232-8406 | 2019-01-22 |
| 1003313180 | Ochsner Mississippi, LLC | Internal Medicine | 4550 Shepherd Sq, Diamondhead, MS 39525-3325 | 2018-04-06 |
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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.