Individual provider Active NPI

Beth Marie Agan, PA-C

  • Physician Assistant
  • Mount Carmel, IL
National Provider Identifier
1295200319
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1527 College Dr.
Mt. Carmel, IL 62863
Phone
(618) 263-6400
NPI assigned
Oct 4, 2018
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1527 College Dr.
Mt. Carmel, IL 62863

Mailing address

1349 W Chukar Holw
Haubstadt, IN 47639-8684
Phone (812) 598-4858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20181227002429 IL Practitioner - Physician Assistant 9931444619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wabash General Hospital DistrictGroup PAC ID 8022908185, 77 clinicians

Practice addresses (Care Compare)

11362 Country Club Rd
Lawrenceville, IL 62439-4325
Phone (618) 707-4360

1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 262-8621

929 Stacey Burk Dr
Flora, IL 62839-3241
Phone (618) 508-8020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wabash General Hospital District Current Accepting new patients
Wabash General Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Wabash General Hospital District CurrentSince Nov 14, 2018 Accepting new patients

Locations

209 NW 11th St
Fairfield, IL 62837
Phone 61872424011624

929 Stacey Burk Dr
Flora, IL 62839

11362 Country Club Rd
Lawrenceville, IL 62439
Phone (618) 707-4360

1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621

1525 College Dr
Mount Carmel, IL 62863
Phone (618) 263-6343

504 Micah Dr
Olney, IL 62450
Phone (618) 395-4306

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 4

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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1295200319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 W CHUKAR HOLW",
            "city": "HAUBSTADT",
            "state": "IN",
            "postal_code": "476398684",
            "telephone_number": "812-598-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 COLLEGE DR.",
            "city": "MT. CARMEL",
            "state": "IL",
            "postal_code": "62863",
            "telephone_number": "618-263-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAN",
        "first_name": "BETH",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, IL

Sources for this page

Verify at the official NPI Registry.