Beacon Health Ventures, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

15-005298-1 Issued in IN

Legal business name

BEACON HEALTH VENTURES, INC.

Practice address

5155 Verdant Drive
Elkhart, IN 46516-5411

Phone

(574) 294-6181

NPI assigned

Jul 2, 2012

Last updated

Feb 16, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra Smigielski

Title

Manager

Phone

(574) 647-8731

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Beacon Health Ventures Inc

  dba Beacon HC Pharmacy ELK

  • Home Infusion Therapy Pharmacy
  • Elkhart, IN
  • NPI 1477816080

  Member Of

  NPD member
• Beacon Medical Group, Inc.

  dba Beacon Medical Group Specialists Bremen

  • Podiatrist
  • Bremen, IN
  • NPI 1558652347

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Frederick Hagenow, M.D.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1568450732
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1053675363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351781",
            "telephone_number": "574-647-8731",
            "fax_number": "574-647-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 VERDANT DRIVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465165411",
            "telephone_number": "574-294-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH VENTURES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "SMIGIELSKI",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "574-647-8731"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "15-005298-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Beacham
• Beacon Health Ventures Inc
• Beacon Health Ventures Inc
• Beacon Health Ventures Inc (Beacon HC Pharmacy ELK)
• Beacon Health Ventures Inc
• Beacon Medical Group Inc (Beacon Medical Group Anesthesia Elkhart)
• Beacon Medical Group Inc. (Beacon Medical Group Concord Specialty Clinic)
• Beacon Medical Group, Inc.
• Beacon Medical Group, Inc.
• Beacon Medical Group, Inc. (Beacon Medical Group OBGYN River Oaks)

• Home Health Agency in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.