TIMOTHY BEACHAM (NPI# 1669670360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669670360 |
| Entity Type | Individual |
| Full Name | TIMOTHY BEACHAM |
| Credential | MD |
| Practice Address |
3841 Ruckriegel Pkwy Ste 104 Louisville KY 40299 |
| Mailing Address |
7951 Shoal Creek Blvd Ste 300 Austin TX 78757-7582 |
| Practice Telephone | 5027918700 |
| Practice Fax Number | 5027428523 |
| Mailing Telephone | 5125848404 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2018-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 20443 | MS | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
49929 | KY | Allopathic & Osteopathic Physicians |
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
20443 | MS | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
20443 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE PTAN | 343174YXV2 | 01 |
| MS | MEDICARE PTAN | 302I057501 | 01 |
| MS | 04330519 | 05 | |
| KY | 7100473360 | 05 |
| Street Address |
3841 RUCKRIEGEL PKWY STE 104 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104811603 | Shaun Wright Nelson | Physician Assistant | 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299-3986 | 2005-09-12 |
| 1710467287 | Capitol Pain Institute | Durable Medical Equipment & Medical Supplies | 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299-3986 | 2018-08-15 |
| 1053807206 | Capitol Pain of Kentucky, Pllc | Anesthesiology | 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299 | 2018-07-10 |
| 1912459264 | Anesthesia Services Associates, Pllc. | Durable Medical Equipment & Medical Supplies | 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299-3986 | 2016-11-02 |
| 1033414370 | Carol Ann Crase | Nurse Practitioner | 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299-3986 | 2011-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477050144 | Jolanta Staniszewska | Social Worker | 1700 Cargo St, Louisville, KY 40299 | 2018-04-10 |
| 1780192302 | Chris Mcclain | Pharmacist | 1901 Campus Place, Suite 100, Louisville, KY 40299 | 2018-01-17 |
| 1669984209 | Bluegrass Allergy Asthma and Immunology Psc | Internal Medicine | 11900 Plantside Dr Ste 9, Louisville, KY 40299 | 2017-11-03 |
| 1588182109 | Hollie Marie Wheeler | Speech-Language Pathologist | Paragon Rehabilitation 2701 Chesnut Station Court, Louisville, KY 40299 | 2017-09-04 |
| 1790206464 | Farrah Hill Rodgers | Occupational Therapy Assistant | 2701 Chestnut Station Court., Paragon Rehabilitation, Louisville, KY 40299 | 2017-07-03 |
| 1871972620 | Jag Medical LLC | Pharmacy | 9813 Merioneth Dr, Louisville, KY 40299 | 2015-05-27 |
| 1023496205 | Scotty Ray Newcomer | Family Medicine | 8511 Watterson Trl, Louisville, KY 40299 | 2015-05-08 |
| 1386048262 | Daniel Gerhard Eschenbach | Dentist | 12613 Taylorsville Rd., Suite #17, Louisville, KY 40299 | 2014-10-21 |
| 1740616192 | Alyse C Martin | Nurse Practitioner | 9569 Taylorsville Road Suite 109, Louisville, KY 40299 | 2013-09-17 |
| 1407104128 | Tammy Rowland Reddington | Nurse Practitioner | 4004 Hurstbroune Woods Drive, Louisville, KY 40299 | 2012-08-28 |
| Find all providers in zip 40299 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447645403 | Vinayak Nadar | Anesthesiology | 1013 N Dupont Sq Ste A, Louisville, KY 40207-4612 | 2015-04-06 |
| 1114311073 | William Bickers | Anesthesiology | 530 S Jackson St Rm C2a01, Department of Anesthesiology and Perioperative Medicine, Louisville, KY 40202-1675 | 2015-03-27 |
| 1386088508 | Brooke Bauer | Anesthesiology | 2400 Eastpoint Pkwy Ste 410, Louisville, KY 40223-4154 | 2013-04-18 |
| 1609854520 | Michael C Cronen | Anesthesiology | 252 Whittington Parkway, Louisville, KY 40222-4904 | 2006-01-03 |
| 1053807206 | Capitol Pain of Kentucky, Pllc | Anesthesiology | 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299 | 2018-07-10 |
| 1992219174 | Noelle Allison Lang | Anesthesiology | 11901 Standiford Plaza Dr, Louisville, KY 40229 | 2017-11-26 |
| 1457712366 | Steven Thebaud | Anesthesiology | 530 S Jackson St Rm C2a03, Louisville, KY 40202-1675 | 2016-03-19 |
| 1740611185 | University of Louisville Research Foundation | Anesthesiology | 530 S Jackson St, Louisville, KY 40202-1675 | 2013-12-11 |
| 1780909952 | Jenna Leigh Dismore Wrinkles | Anesthesiology | 120 Executive Park, Louisville, KY 40207-4201 | 2010-03-31 |
| 1770716870 | Portercare Adventist Health System | Anesthesiology | 80 Health Park Dr, Suite 270, Louisville, CO 80027-9584 | 2009-08-24 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40299 |
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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.