BEACON MEDICAL GROUP, INC. (NPI# 1487036869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487036869 |
| Entity Type | Organization |
| Organization Name | BEACON MEDICAL GROUP, INC. |
| Other Organization Name | BEACON MEDICAL GROUP- BUCHANAN |
| Practice Address |
804 E Front St Buchanan MI 49107-1444 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 2696953897 |
| Practice Fax Number | 2696956407 |
| Mailing Telephone | 5746471610 |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2016-09-20 |
| Authorized Official Name | MR. JEFFREY P. COSTELLO (CFO) |
| Authorized Official Telephone | 5746473549 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEACON HEALTH SYSTEM, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Beacon Medical Group- Buchanan | Doing Business As Name - Organization |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEACON MEDICAL GROUP, INC. | 4601 Glendale Court, Savage, MN 55378-2543 |
| Street Address |
804 E FRONT ST |
| City | BUCHANAN |
| State | MI |
| Zip Code | 49107-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457313926 | Harold E Brown | Family Medicine | 804 E Front St, Buchanan, MI 49107-1444 | 2006-04-03 |
| 1467603746 | Elkhart Clinic, LLC | Urology | 804 E Front St, Buchanan, MI 49107-1444 | 2008-10-06 |
| 1851592935 | Michiana Urology PC | Urology | 804 E Front St, Buchanan, MI 49107-1444 | 2007-05-29 |
| 1265488142 | Harold Brown Md | Family Medicine | 804 E Front St, Buchanan, MI 49107-1444 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447453188 | Ronald C Carr | Dentist | 802 East Front St, Ste 5, Buchanan, MI 49107 | 2007-06-08 |
| 1669696464 | Barbara A Starke | Registered Nurse | 804 E Front Street, Buchanan, MI 49107 | 2007-04-12 |
| 1558338368 | Respiratory Home Care & Convalescent Supply Inc | Durable Medical Equipment & Medical Supplies | 320 N Redbud Trail, Buchanan, MI 49107 | 2006-03-01 |
| 1255827382 | Kari Mitchell-coplen | Physical Therapy Assistant | 500 E 3rd St, Buchanan, MI 49107 | 2018-07-01 |
| 1790294064 | Red Bud Health Services LLC | Physical Therapist | 500 E 3rd St, Buchanan, MI 49107 | 2017-09-29 |
| 1457743486 | Audrey Lynn Carrier | Family Medicine | 1045 E Front St, Buchanan, MI 49107 | 2015-02-27 |
| 1740801653 | Sharon M Bradley | Nursing Care | 324 N Detroit St, Buchanan, MI 49107-1204 | 2020-05-01 |
| 1235526260 | Into His Rest Ministries | Social Worker | 102 Elizabeth St, Buchanan, MI 49107-1327 | 2015-04-16 |
| 1851443956 | Drs Steven and Brenda Smoke Od PC | Optometrist | 400 E Front St, Suite A, Buchanan, MI 49107-1403 | 2007-01-17 |
| 1306998919 | Brenda Dani Smoke | Optometrist | 400 E Front St Ste A, Buchanan, MI 49107-1403 | 2007-01-17 |
| Find all providers in zip 49107 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700990074 | Roy B Parke | Family Medicine | 257 E Front St, Buchanan, MI 49107-1407 | 2006-08-17 |
| 1114958550 | Colin W Elliott | Family Medicine | 802 1/2 East Front Street, Buchanan, MI 49107-1444 | 2006-07-05 |
| 1457313926 | Harold E Brown | Family Medicine | 804 E Front St, Buchanan, MI 49107-1444 | 2006-04-03 |
| 1508837741 | David H Johnson | Family Medicine | 18080 Main St, Buchanan, VA 24066-5482 | 2006-01-27 |
| 1568911980 | Lakeland Medical Practices | Family Medicine | 1045 E Front St, Suite A, Buchanan, MI 49107-8474 | 2016-09-27 |
| 1639520851 | Lakeland Medical Practice | Family Medicine | 1045 E Front St, Suite A, Buchanan, MI 49107-8474 | 2016-06-29 |
| 1457743486 | Audrey Lynn Carrier | Family Medicine | 1045 E Front St, Buchanan, MI 49107 | 2015-02-27 |
| 1811282346 | Johannes D Engelbrecht | Family Medicine | 30 Buchanan Byp, Buchanan, GA 30113-4924 | 2011-06-13 |
| 1275687147 | Roy B Parke D.o. | Family Medicine | 1045 E Front St, Buchanan, MI 49107-8474 | 2007-01-22 |
| 1497781660 | Nilgun Camilla Frengell | Family Medicine | 1045 E Front St, Suite A, Buchanan, MI 49107-8474 | 2006-06-22 |
| Find all providers in BUCHANAN | ||||
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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.