Organization Active NPI

Beacon of Health Family Chiropractic and Natural Medicine Center, Inc.

  • Clinic/Center
  • Lake Havasu City, AZ
National Provider Identifier
1174876015
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
8291 Issued in AZ
Legal business name
BEACON OF HEALTH FAMILY CHIROPRACTIC AND NATURAL MEDICINE CENTER, INC.
Practice address
1956 Mesquite Ave
#103
Lake Havasu City, AZ 86403-5888
Phone
(928) 854-8005
Fax
(928) 854-8006
NPI assigned
Oct 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Dr. Jennifer Nicole Rusch Garcia, D.C.NPI 1174896948
Title
Chiropractic Physician/Owner
Phone
(928) 854-8005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 8291 AZ Primary

Addresses

Primary practice location

1956 Mesquite Ave
#103
Lake Havasu City, AZ 86403-5888

Mailing address

1956 Mesquite Ave
#103
Lake Havasu City, AZ 86403-5888
Phone (928) 854-8005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130206000001 AZ Part B Supplier - Clinic/Group Practice 3971757691 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Havasu City, AZ

National Provider Directory

National Provider Directory

Locations

430 Lake Havasu Ave S
Ste 102
Lake Havasu City, AZ 86403
Phone (928) 854-8005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1174876015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 MESQUITE AVE",
            "address_2": "#103",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035888",
            "telephone_number": "928-854-8005",
            "fax_number": "928-854-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 MESQUITE AVE",
            "address_2": "#103",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035888",
            "telephone_number": "928-854-8005",
            "fax_number": "928-854-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF HEALTH FAMILY CHIROPRACTIC AND NATURAL MEDICINE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NICOLE RUSCH",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "928-854-8005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "8291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.