Individual provider Active NPI

Beth A Jones, NP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1215508569
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011285A Issued in IN
Practice address
611 E Douglas Rd Ste 305
Mishawaka, IN 46545-1467
Phone
(574) 335-6450
Fax
(574) 335-0643
NPI assigned
Jul 8, 2021
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011285A IN Primary

Addresses

Primary practice location

611 E Douglas Rd Ste 305
Mishawaka, IN 46545-1467

Mailing address

611 E Douglas Rd Ste 305
Mishawaka, IN 46545-1467

Other identifiers 1

IdentifierTypeStateIssuer
300052777MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723001812 IN Practitioner - Nurse Practitioner 7810390192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

611 E Douglas Rd
305 Neurology
Mishawaka, IN 46545-1467
Phone (574) 335-6450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011285AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc CurrentSince Aug 30, 2021 Accepting new patients
Saint Joseph Regional Medical Center, Inc. CurrentSince Nov 14, 2025 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family CurrentSince Nov 14, 2025 Accepting new patients
Goshen Health System Inc CurrentSince Aug 30, 2021 Accepting new patients

Locations

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

2832 Elkhart Rd
Goshen, IN 46526
Phone (574) 533-7476

611 E Douglas Rd
Ste 305
Mishawaka, IN 46545
Phone (574) 335-6450

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1215508569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 305",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 305",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451467",
            "telephone_number": "574-335-6450",
            "fax_number": "574-335-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "BETH",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011285A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300052777",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.