BEACON MEDICAL GROUP INC (NPI# 1205887817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205887817 |
| Entity Type | Organization |
| Organization Name | BEACON MEDICAL GROUP INC |
| Other Organization Name | MICHIANA ARTHRITIS & OSTEOPOROSIS CENTER |
| Practice Address |
707 N Michigan St Suite 102 South Bend IN 46601-1067 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5746474500 |
| Mailing Telephone | 5746471610 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-05-13 |
| Authorized Official Name | JEFFREY COSTELLO (VP-CFO) |
| Authorized Official Telephone | 5746473549 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
01061323A | IN | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Michiana Arthritis & Osteoporosis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942781109 | Beacon Medical Group Inc | Family Medicine | 1144 W Plymouth St, Bremen, IN 46506-1842 | 2018-08-27 |
| 1124071246 | Beacon Medical Group Inc | Obstetrics & Gynecology | 100 Navarre Pl, Suite 4470, South Bend, IN 46601-1156 | 2006-05-18 |
| Street Address |
707 N MICHIGAN ST SUITE 102 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619971488 | Thomas Edward Capannari | Pediatrics | 707 N Michigan St, Ste 316, South Bend, IN 46601 | 2005-06-09 |
| 1588205231 | Patrick Murathimi Mutugu | Registered Nurse | 707 N Michigan St, South Bend, IN 46601-1067 | 2019-10-03 |
| 1952969115 | Caitlin Casey | Student in an Organized Health Care Education/Training Program | 707 N Michigan St, South Bend, IN 46601-1067 | 2019-06-03 |
| 1033520101 | Oluyinka Grace Osunnuga | Nurse Practitioner | 707 N Michigan St, Suite 400, South Bend, IN 46601-1067 | 2014-05-12 |
| 1003172719 | Beth Ann Hayden | Nurse Practitioner | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2012-04-06 |
| 1447520291 | Advanced Center for Cardiothoracic Surgery LLC | Clinic/Center | 707 N Michigan St, 503, South Bend, IN 46601-1067 | 2012-01-11 |
| 1679707012 | Narendra Pratap Singh | Psychiatry & Neurology | 707 N Michigan St, Suite 400, South Bend, IN 46601-1067 | 2009-05-13 |
| 1275705691 | Jagadeesh Reddy | Psychiatry & Neurology | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2008-03-26 |
| 1457536336 | Cardiothoracic Surgery, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 707 N Michigan St, Suite 501, South Bend, IN 46601-1067 | 2008-01-09 |
| 1508080714 | Duane D Flaig | Nurse Practitioner | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2007-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700927811 | Arthritis Care of Michiana LLC | Internal Medicine | 100 Navarre Pl Ste 5570, South Bend, IN 46601-1169 | 2007-02-09 |
| 1124057419 | Alan J Birnbaum | Internal Medicine | 100 Navarre Pl, Suite 5570, South Bend, IN 46601-1169 | 2006-07-01 |
| 1710977319 | Brent W Mohr | Internal Medicine | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477047256 | American Arthritis & Rheumatology Associates In LLC | Internal Medicine | 18077 River Rd Ste 206, Noblesville, IN 46062-8334 | 2018-06-15 |
| 1457708000 | Union Associated Physicians Clinic, LLC | Internal Medicine | 1711 N 6th 1/2 St Ste 302, Terre Haute, IN 47804-2770 | 2016-05-24 |
| 1972855138 | Rheumetology Arthritis Immunology | Internal Medicine | 4933 Plaza East Blvd, Evansville, IN 47715-2813 | 2012-10-11 |
| 1407167273 | Anan Bassam Afaneh | Internal Medicine | 6905 E 96th St Ste 300, Indianapolis, IN 46250-4456 | 2010-06-28 |
| 1306161955 | Kirk Jenkins | Internal Medicine | 1461 Morthland Dr Ste A, Valparaiso, IN 46385-6362 | 2010-04-06 |
| 1053598896 | Tracy M. Brenner | Internal Medicine | 8902 N Meridian St #210, Indianapolis, IN 46260-5307 | 2008-01-23 |
| 1528248242 | Reddy Rheumatology of Northwest In PC | Internal Medicine | 118 E 90th Drive, Merrillville, IN 46410-7160 | 2007-11-09 |
| 1538225487 | Kimberly Shaw Lamberson | Internal Medicine | 1001 West 10th Street, Wishard Hospital, Indianapolis, IN 46202 | 2006-12-28 |
| 1134202880 | William Parker Rusche | Internal Medicine | 3316 E Mulberry Dr, Bloomington, IN 47401-2426 | 2006-10-23 |
| 1669560215 | Mohsen Ehsan | Internal Medicine | 1919 State St Ste 244, New Albany, IN 47150-6804 | 2006-10-10 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
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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.