KEITH ALAN BEAUCHAMP (NPI# 1437150117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437150117 |
| Entity Type | Individual |
| Full Name | KEITH ALAN BEAUCHAMP |
| Credential | D.P.M. |
| Practice Address |
106 Butler St Suite A Macon MO 63552-1629 |
| Mailing Address |
106 Butler St P.o. Box 447 Macon MO 63552-1629 |
| Practice Telephone | 6603854464 |
| Practice Fax Number | 6603851449 |
| Mailing Telephone | 6603854464 |
| Mailing Fax Number | 6603851449 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2014-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 000737 | MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 308527605 | 05 | |
| MO | MEDICAID DME | 626227508 | 01 |
| Street Address |
106 BUTLER ST SUITE A |
| City | MACON |
| State | MO |
| Zip Code | 63552-1629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306197918 | Macon Rehabilitation Services, LLC | Clinic/Center | 106 Butler St, Suite C, Macon, MO 63552-1629 | 2012-09-21 |
| 1114274503 | Derek Bond | Physical Therapist | 106 Butler St, Macon, MO 63552-1629 | 2012-08-06 |
| 1154368413 | Joseph E Quaranto | Family Medicine | 106 Butler St, Macon, MO 63552-1629 | 2006-06-02 |
| 1386636793 | Kathy S Abernathy | Physical Therapist | 106 Butler St, Suite C, Macon, MO 63552-1629 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1477624161 | Charles Edgar Averill Jr. | Occupational Therapist | 704a South Missouri, Macon, MO 63552 | 2006-11-13 |
| 1629035084 | Missouri Cvs Pharmacy, L.L.C. | Pharmacy | 1105 N Rutherford St, Macon, MO 63552 | 2006-04-28 |
| 1659560688 | Iris Ladawn Gaerditz | Speech-Language Pathologist | 702 N Missouri St, Macon, MO 63552 | 2007-10-16 |
| 1841316296 | Paul Vincent Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-03-21 |
| 1891908612 | Mid Missouri Physical Therapy | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-05-08 |
| 1366568735 | Lara Beth Jones | Physical Therapist | 2005 N. Missouri St., Suite D., Macon, MO 63552-0381 | 2007-03-21 |
| 1871619262 | Abby M Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0387 | 2007-03-21 |
| 1457715906 | Kimberly Oroke | Social Worker | 821 Charles St, Columbia, MO 63552-1064 | 2016-04-11 |
| 1679100507 | Macon County Sheltered Workshop | Private Vehicle | 1103 Enterprise Rd, Macon, MO 63552-1305 | 2020-03-23 |
| Find all providers in zip 63552 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700440401 | Pamela Onderko Dpm LLC | Podiatrist | 5223 Riverside Dr Ste 104, Macon, GA 31210-0889 | 2019-04-28 |
| 1083842637 | Irma Wejuli | Podiatrist | 6416 Peake Road, #18, Macon, GA 31210 | 2009-06-22 |
| 1437396447 | Village Podiatry Group, LLC. | Podiatrist | 3556 Riverside Drive, Macon, GA 31210-2509 | 2009-01-13 |
| 1104015189 | Family Foot Clinic | Podiatrist | 1501 N Missouri St, Macon, MO 63552-1969 | 2007-10-16 |
| 1104832484 | Katanga Mccoy | Podiatrist | 940 Pio Nono Ave, Macon, GA 31204-4059 | 2006-07-31 |
| 1780602011 | Consuela Maria Williams-holliday | Podiatrist | 440 Charter Blvd, Ste 2202, Macon, GA 31210-0705 | 2006-07-17 |
| 1154398402 | Roger Peter Theodore | Podiatrist | 841 Mulberry St, Macon, GA 31201 | 2006-03-07 |
| 1114901956 | Joseph Michael Union | Podiatrist | 2180 Vineville Ave, Macon, GA 31204-3124 | 2005-12-05 |
| 1366796930 | Village Podiatry Group, LLC | Podiatrist | 770 Pine St, Ste 300, Macon, GA 31201-2173 | 2012-11-05 |
| 1922238047 | S.e. Family Foot & Ankle Center LLC | Podiatrist | 841 Mulberry St, Macon, GA 31201-6756 | 2009-07-23 |
| Find all providers in MACON | ||||
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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.