JERRY STEPHEN BEASLEY (MD) – Family Medicine Physician, NPI 1144312869

JERRY STEPHEN BEASLEY (MD) is a healthcare provider. based in Pulaski, Tennessee. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 26439 (TN). The NPI Number for JERRY STEPHEN BEASLEY (MD) is 1144312869

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
JERRY STEPHEN BEASLEY (MD)
NPI
1144312869
Phone
(931) 424-8881
Address
1119 E COLLEGE ST
Enumeration Date
29 September 2006
Last Update Date
23 June 2010

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
9313633514
Graduation Year
1982 (44 years ago)
PAC ID
9739179235
Group Practice PAC ID
9436240017
Professional Enrollment ID
I20040517000407
Address ID
TN384784566PU204XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,210 FAMILY PRACTICE in TN

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Provider Addresses for JERRY STEPHEN BEASLEY (MD)

  • 1119, East College Street, Rebel Acres, Pulaski, Giles County, Tennessee, 38478, United States

    STE 3

    PULASKI, TN 38478

    Phone: (931) 424-8881

    Fax: (931) 424-5385

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040517000407IFamily PracticeTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38478)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436240017View full group profile
NameSpecialtyState
Nurse PractitionerTN
Nurse PractitionerTN
General SurgeryTN
Nurse PractitionerTN
-TN
Sports Medicine, Orthopedic SurgeryTN
Nurse PractitionerTN
Family PracticeTN
Nurse PractitionerTN
O B S T E T R I C S/ G Y N E C O L O G YNY

Reviews

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Frequently asked questions

Can I use this page to confirm JERRY STEPHEN BEASLEY (MD)'s NPI?
Yes. JERRY STEPHEN BEASLEY (MD) is listed with NPI 1144312869 in the public NPI dataset.
Does CMS list JERRY STEPHEN BEASLEY (MD) as active?
Yes — JERRY STEPHEN BEASLEY (MD) is active in the NPI listing used on this page.
What is JERRY STEPHEN BEASLEY (MD)'s primary classification?
Family Medicine Physician is the headline specialty for JERRY STEPHEN BEASLEY (MD) here. Clinical services aligned with this taxonomy classification.
Where is JERRY STEPHEN BEASLEY (MD) based?
JERRY STEPHEN BEASLEY (MD) is tied to Pulaski, Tennessee in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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