TIMOTHY MANSON BEATY (NPI# 1740399674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740399674 |
| Entity Type | Individual |
| Full Name | TIMOTHY MANSON BEATY |
| Credential | M.D. |
| Practice Address |
9401 Holy Cross Ln Suite 112 Breese IL 62230-3510 |
| Practice Telephone | 6185267271 |
| Practice Fax Number | 6185267313 |
| Mailing Telephone | 6185267271 |
| Mailing Fax Number | 6185267313 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036094492 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036094492 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477796258 | Timothy C. Beaty | Pediatrics | 1315 Jefferson Hwy, New Orleans, LA 70121 | 2009-04-09 |
| Street Address |
9401 HOLY CROSS LN SUITE 112 |
| City | BREESE |
| State | IL |
| Zip Code | 62230-3510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083612790 | Renato Bacol Rivera | Surgery | 9401 Holy Cross Ln, Suite 111, Breese, IL 62230-3510 | 2005-07-07 |
| 1417252453 | Amber Leigh Poettker | Physician Assistant | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2011-01-24 |
| 1174732945 | Douglas M. Kuhl | Pediatrics | 9401 Holy Cross Ln, Suite 112b, Breese, IL 62230-3510 | 2007-05-21 |
| 1477618734 | Fred Charles Boch | Social Worker | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-12-27 |
| 1013027945 | Roch Andre Lefebvre | Family Medicine | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-08-30 |
| 1326158254 | Jonathan Vaughn Osborn | Family Medicine | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-08-30 |
| 1851401715 | Paula Robin Griffee-wilcox | Physician Assistant | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-08-30 |
| 1265542120 | Amy Kathleen Krause | Physician Assistant | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-08-30 |
| 1811945264 | David L Neighbors | Family Medicine | 9401 Holy Cross Ln, Breese, IL 62230-3510 | 2006-05-05 |
| 1992772289 | David Louis Kee | Podiatrist | 9401 Holy Cross Ln, Suite 115, Breese, IL 62230-3510 | 2006-03-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841738457 | Coping 4 Kids | Social Worker | 900 N Walnut St., Breese, IL 62230 | 2017-02-02 |
| 1528505146 | Danielle Mueller | Licensed Practical Nurse | 604 North Chestnut, Breese, IL 62230 | 2017-01-20 |
| 1104000561 | Competitive Edge Sports Medicine | Family Medicine | 14160 Jamestown Rd, Breese, IL 62230 | 2007-12-20 |
| 1063606978 | Clarkson Optometry Illinois PC | Optometrist | 103 Clintonian Plaza, Breese, IL 62230 | 2007-09-04 |
| 1013002658 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Family Medicine | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2006-10-03 |
| 1730287434 | Breese Dental Group PC. | Dentist | 9437 Holy Cross Ln., Breese, IL 62230 | 2006-09-20 |
| 1144328832 | Joe Cao Truong | Dentist | 9437 Holy Cross Lane, Breese, IL 62230 | 2006-09-20 |
| 1356391155 | Timothy H Droege | Dentist | 111 North Main, Breese, IL 62230 | 2006-05-11 |
| 1346206042 | Thomas B Doyle | Radiology | 9515 Holy Cross Lane, Breese, IL 62230 | 2006-04-22 |
| 1346730561 | Amanda Walden | Nurse Practitioner | 9401 Holy Cross Ln Ste 112, Breese, IL 62230 | 2018-05-14 |
| Find all providers in zip 62230 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013002658 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Family Medicine | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2006-10-03 |
| 1730600644 | Jonathan Dennis Hoskins | Family Medicine | 9401 Holy Cross Ln Ste 112, Breese, IL 62230-3510 | 2017-06-30 |
| 1518049204 | Douglas A Kruse Md LLC | Family Medicine | 9495 Holy Cross Ln, Suite 103, Breese, IL 62230-3510 | 2006-10-20 |
| 1013027945 | Roch Andre Lefebvre | Family Medicine | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-08-30 |
| 1326158254 | Jonathan Vaughn Osborn | Family Medicine | 9401 Holy Cross Ln, Suite 112, Breese, IL 62230-3510 | 2006-08-30 |
| 1194830661 | Douglas Anthony Kruse | Family Medicine | 9495 Holy Cross Ln, Suite 103, Breese, IL 62230-3510 | 2006-08-21 |
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| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
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| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
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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.