Beacon Health Ventures Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

69000136A Issued in IN

Legal business name

BEACON HEALTH VENTURES INC

Practice address

2602 South U.S. 35
Knox, IN 46534

Phone

(574) 772-4458

NPI assigned

Nov 13, 2006

Last updated

Feb 27, 2017By 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

Gregory M Conrad

Title

President

Phone

(574) 647-8777

Specialties & licenses 1

Addresses

Other identifiers 2

Member of 1

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

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Specialists Bremen

  • Podiatrist
  • Bremen, IN
  • NPI 1558652347

  Member Of

  NPD member

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1225100787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS ROAD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351780",
            "telephone_number": "574-273-2273",
            "fax_number": "574-273-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 SOUTH U.S. 35",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "46534",
            "telephone_number": "574-772-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH VENTURES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-647-8777"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000136A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200253800B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER",
            "identifier": "000000097412",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thomas Michael Browne, M.D.
• Michelle Burbank, LCSW
• Brooke V Butler, FNP
• Cancer Health Treatment Centers,P.C.

• Durable Medical Equipment & Medical Supplies in Knox, IN
• Providers in Knox, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.