Provider Demographics
NPI:1306828702
Name:BEAMON, RICHARD F (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:BEAMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 838
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66201-0838
Mailing Address - Country:US
Mailing Address - Phone:913-469-4244
Mailing Address - Fax:913-469-1939
Practice Address - Street 1:10500 QUIVIRA RD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-469-4244
Practice Address - Fax:913-469-1939
Is Sole Proprietor?:No
Enumeration Date:2005-11-19
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35126207P00000X
KS417779207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100137040RMedicaid
KS1306828702OtherBLUE SHIELD
KS58214Medicare PIN
KSJ673583Medicare PIN
KSKA1398015Medicare PIN
KS106204Medicare PIN
KSR863583BMedicare PIN
KSKA1053015Medicare PIN
MOR863583AMedicare PIN
KS1306828702OtherBLUE SHIELD
KS100137040RMedicaid
MON533583Medicare PIN
KS102976Medicare PIN