BEACON MEDICAL GROUP, INC.


Address: 926 Erskine Plz, South Bend, IN 46614-3244
Phone: 8006355516

BEACON MEDICAL GROUP, INC. (NPI# 1083665673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083665673
Entity Type Organization
Organization Name BEACON MEDICAL GROUP, INC.
Other Organization Name MEDPOINT EXPRESS
Practice Address 926 Erskine Plz
South Bend
IN 46614-3244
Mailing Address 710 N Niles Ave
South Bend
IN 46617-1924
Practice Telephone 8006355516
Practice Fax Number 5746476514
Mailing Telephone 5746471610
Enumeration Date 2006-05-16
Last Update Date 2016-08-29
Authorized Official Name JEFFREY P. COSTELLO (VP-CFO)
Authorized Official Telephone 5746473549
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 71000651A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 200130710J 05
IN 200130710H 05
IN 200130710I 05
IN 200130710K 05

Other Provider/Organization Names

Other Name Type Code
MedPoint Express Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1487038360 Beacon Medical Group, Inc. Radiology 233 Florence Ave, Granger, IN 46530-8048 2015-07-10
1124423546 Beacon Medical Group, Inc. Internal Medicine 100 Navarre Pl Ste 4400, South Bend, IN 46601-1100 2014-10-28
1487061131 Beacon Medical Group, Inc. Internal Medicine 2400 N Ventura Way, Lagrange, IN 46761-4101 2014-07-15
1437574530 Beacon Medical Group, Inc. Otolaryngology 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 2014-02-26
1528362647 Beacon Medical Group, Inc. Internal Medicine 500 Arcade Ave., Suite 400, Elkhart, IN 46514 2011-01-04
1699794057 Beacon Medical Group, Inc. Internal Medicine 500 Arcade Ave Ste 300, Elkhart, IN 46514-2486 2006-07-18
1205852365 Beacon Medical Group, Inc. Family Medicine 27082 W. Main Street, Edwardsburg, MI 49112-9334 2006-07-14
1861421141 Beacon Medical Group, Inc. Psychiatry & Neurology 100 Navarre Pl Ste 6600, South Bend, IN 46601 2006-06-30
1467408237 Beacon Medical Group, Inc. Pediatrics 615 N Michigan St Fl 5, South Bend, IN 46601 2006-05-25
1275587149 Beacon Medical Group, Inc. Family Medicine 813 S Michigan St, South Bend, IN 46601 2006-05-22

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities BEACON MEDICAL GROUP, INC. 4601 Glendale Court, Savage, MN 55378-2543

Office Location

Street Address 926 ERSKINE PLZ
City SOUTH BEND
State IN
Zip Code 46614-3244

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396824108 Martin's Super Markets Pharmacy 926 Erskine Plz, South Bend, IN 46614-3244 2006-11-03
1629015193 Robin L Hass Nurse Practitioner 926 Erskine Plz, Medpoint Express, South Bend, IN 46614-3244 2006-06-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417574013 Hellen Gathesha Nurse Practitioner 2123 W Irvington Dr, South Bend, IN 46614 2020-06-30
1033759394 Diane Galvas Pharmacist 1217 E. Ireland Rd., South Bend, IN 46614 2020-01-14
1730668690 Julenne Henriquez-gil Physical Therapist 202 W Ireland Rd Ste 101a, South Bend, IN 46614 2018-08-11
1467747014 Deidre A Coffey Nurse Practitioner 1025 Widener Ln, South Bend, IN 46614 2011-06-12
1588727655 Wal-mart Stores East, Lp Technician/Technologist 700 W. Ireland Rd., South Bend, IN 46614 2006-12-19
1437262847 Lori F Risser Dentist 734 E Ireland Rd, South Bend, IN 46614 2006-08-17
1912388018 Laura Ellen Albright Family Medicine 2102 E Inwood Rd, South Bend, IN 46614 2015-06-15
1245626225 Kathleen Kelley Dermatology 1815 E Ireland Rd, South Bend, IN 46614 2015-04-07
1073869806 The Health and Hospital Corporation of Marion County Skilled Nursing Facility 1950 Ridgedale Rd, South Bend, IN 46614 2012-07-30
1326300666 Kristine Marie Jones Optometrist 700 W Ireland Rd, South Bend, IN 46614 2012-06-12
Find all providers in zip 46614

Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417574013 Hellen Gathesha Nurse Practitioner 2123 W Irvington Dr, South Bend, IN 46614 2020-06-30
1073042024 Emilee Tehrani Nurse Practitioner 621 Memorial Dr Ste 512, South Bend, IN 46601-1075 2017-06-05
1952836884 Ryan Ford Nurse Practitioner 2301 N Bendix Dr Ste 500, South Bend, IN 46628-3488 2017-04-28
1124563614 Alexandrea Burnett Nurse Practitioner 211 N. Eddy St., South Bend, IN 46617-3096 2016-12-20
1265700090 Gregory George Bingaman Nurse Practitioner 710 N Niles Ave, South Bend, IN 46617-1924 2011-12-07
1679768774 Kyra Dee Tatman Nurse Practitioner 615 N Michigan St Ste 502, South Bend, IN 46601-1033 2007-09-11
1386686996 Rhonda Y Griffiths Nurse Practitioner 234 Chapin St, Suite I, South Bend, IN 46601-2570 2006-06-11
1699763409 Patricia Ann Corbett Nurse Practitioner 1708 High St, South Bend, IN 46613-2633 2005-10-06
1760082002 Nicole A Scheidler Nurse Practitioner 211 N Eddy St, South Bend, IN 46617-3096 2020-10-27
1457967275 April Degennaro Nurse Practitioner 826 Alder St, South Bend, WA 98586-4900 2020-09-17
Find all providers in SOUTH BEND

Competitor

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City SOUTH BEND
Zip Code 46614

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Dataset Information

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.

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