CAROLYN ELAINE BEVERLY (NPI# 1356715197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356715197 |
| Entity Type | Individual |
| Full Name | CAROLYN ELAINE BEVERLY |
| Practice Address |
716 Fitzlee St Glasgow VA 24555-2530 |
| Practice Telephone | 5402581098 |
| Mailing Telephone | 5402581098 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2469-01-001 | VA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871933812 | Carolyn Louise Beverly | Preventive Medicine | 3024 Deep Woods Ct, Des Moines, IA 50320-2818 | 2013-07-03 |
| Street Address |
716 FITZLEE ST |
| City | GLASGOW |
| State | VA |
| Zip Code | 24555-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548634900 | Building Bridges Group Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 716 Fitzlee St, Glasgow, VA 24555-2530 | 2015-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154544559 | Robert L Simons Jr. | Dentist | 106 Mclaughlin St, Lexington, VA 24555-2023 | 2007-04-11 |
| 1891746400 | Jane P Sailer | Family Medicine | 730 Mcculloch St, Glasgow, VA 24555-2710 | 2006-05-16 |
| 1346698537 | Elizabeth Berry | Nurse Practitioner | 730 Mcculloch St, Glasgow, VA 24555-2710 | 2016-05-27 |
| 1134597719 | Laura Simpson | Nurse Practitioner | 730 Mcculloch St, Glasgow, VA 24555-2710 | 2015-09-12 |
| 1598801326 | Maury River Family Practice, LLC | Family Medicine | 730 Mcculloch St, Glasgow, VA 24555-2710 | 2007-01-29 |
| 1801909734 | Beth Lawhorne Cullen | Nurse Practitioner | 404 Anderson St, Glasgow, VA 24555-2802 | 2006-08-16 |
| 1467836163 | Cigna Onsite Health LLC | Non-Pharmacy Dispensing Site | 404 Anderson St, Glasgow, VA 24555-2802 | 2015-07-13 |
| 1235315664 | Kathryn Rose Eagle | Contractor | 166 Tinkerville Rd, Glasgow, VA 24555-2962 | 2008-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770837 | Patricia R Mcclure | Technician | 116 4th Avenue, Glasgow, WV 25086 | 2020-11-04 |
| 1710505912 | Adriene Elizabeth Wilson | Nurse Practitioner | 310 N. L. Rogers Blvd., Glasgow, KY 42141 | 2020-07-14 |
| 1649896648 | Katrina Antonette Casanova Tinoco | Student in an Organized Health Care Education/Training Program | 1325 North Race St., University of Louisville/glasgow, Glasgow, KY 42141 | 2020-06-25 |
| 1285263343 | Kara Morgan Harris | Counselor | 108a Ensminger Dr, Glasgow, KY 42141-1157 | 2020-04-02 |
| 1497389506 | Mh Health Care Services, PC | Nurse Practitioner | 1006 Glenview Dr, Glasgow, KY 42141-3424 | 2020-02-27 |
| 1376177956 | Spine Stop Glasgow, Pllc | Chiropractor | 1101 Cleveland Ave, Glasgow, KY 42141-1011 | 2020-02-24 |
| 1407496557 | Total Renal Care, Inc. | Clinic/Center | 310n L Rogers Wells Bldv, Glasgow, KY 42141-1300 | 2020-01-07 |
| 1154967966 | Cumberland Family Medical Center, Inc. | Clinic/Center | 505 Trojan Trail, Glasgow, KY 42141-2214 | 2019-11-27 |
| 1851937908 | Tracy L England | Social Worker | 108 Ensminger Dr Ste A, Glasgow, KY 42141-1157 | 2019-11-25 |
| 1265078455 | Brandi Lynn Knierim | Nurse Practitioner | 24 Newton Ave, Glasgow, MT 59230 | 2019-11-21 |
| Find all providers in GLASGOW | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548634900 | Building Bridges Group Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 716 Fitzlee St, Glasgow, VA 24555-2530 | 2015-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729213 | Saint Claire Healthcare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5601 Seminary Rd Apt 915n, Falls Church, VA 22041-2997 | 2020-10-28 |
| 1780283275 | Great Day Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6606 Gills Gate Pl, Chesterfield, VA 23832-6004 | 2020-10-26 |
| 1306451448 | Nikita S Banks | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 505 Cumberland Street Ave, Ste 2, Portsmouth, VA 23704-2370 | 2020-09-15 |
| 1396359576 | Best Hope Community Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9662 Hawkshead Dr, Lorton, VA 22079-2786 | 2020-09-03 |
| 1609489038 | Viana Healthcare Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8205 Mockingbird Dr, Annandale, VA 22003-3713 | 2020-08-25 |
| 1770196339 | Jilly Healthcare Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4145 Lenox Dr, Fairfax, VA 22032-1112 | 2020-08-24 |
| 1225640279 | Guardian Angels Homecare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1116 Pin Oak Drive, Suffolk, VA 23434-2343 | 2020-08-20 |
| 1659993079 | Collaborative Community LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6000 Filbert Ct, Springfield, VA 22152-1609 | 2020-05-07 |
| 1356962252 | Intellectual Services Group, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4813 Integrity Ct, Fredericksburg, VA 22408-1891 | 2020-05-01 |
| 1699394346 | Peace of Mind Residential Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Pinehurst Ln, Stafford, VA 22554-7288 | 2020-04-13 |
| Find all providers with the same taxonomy | ||||
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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.