THE BEVERLY CLINIC
NPI 1609382209
Clinic/Center - Primary Care in Longview, TX
About The Beverly Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE BEVERLY CLINIC (NPI 1609382209) is a healthcare organization registered as a primary care in Longview, Texas and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through December 10, 2027 and lists Daytral Brown, Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
The Beverly Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to The Beverly Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2141238
Beverly Advanced Practice Nursing Dba The Beverly Clinic · Longview, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Beverly Advanced Practice Nursing, PLLC's NPI number?
The NPI number for Beverly Advanced Practice Nursing, PLLC is 1609382209. It was assigned to this organization in the NPPES registry on December 18, 2017. The provider is doing business as The Beverly Clinic.
Where is Beverly Advanced Practice Nursing, PLLC located?
Beverly Advanced Practice Nursing, PLLC is located at 103A Woodbine Pl, Longview, TX 75601. The listed phone number is (903) 212-7788.
What is Beverly Advanced Practice Nursing, PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Beverly Advanced Practice Nursing, PLLC enrolled in Medicare?
Yes. Beverly Advanced Practice Nursing, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Beverly Advanced Practice Nursing, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Beverly Advanced Practice Nursing, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Beverly Advanced Practice Nursing, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2141238) is associated with this NPI, valid through December 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Beverly Advanced Practice Nursing, PLLC was last updated on December 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# The Beverly Clinic · NPI 1609382209
Primary Care organization in Longview, Texas. Organization record, active in the CMS NPPES registry since December 18, 2017.
## Identity
- **NPI:** 1609382209 (Entity type: Organization)
- **Enumerated:** December 18, 2017
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Beverly Advanced Practice Nursing, Pllc
- **Organization subpart:** No
- **Authorized official:** Daytral Brown, NURSE PRACTITIONER
## Practice location
- **Address:** 103A WOODBINE PL, Longview, TX 75601-2912
- **Phone:** (903) 212-7788
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 18, 2017
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1609382209) · Data from the CMS NPPES public registry.