NPIMap

Organization Active NPI

Beloit Health System, Inc

Doing business as janesville medical center

  • Family Medicine Physician
  • Janesville, WI
National Provider Identifier
1407999337
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BELOIT HEALTH SYSTEM, INC
Doing business as
janesville medical center
Practice address
1321 Creston Park Dr
Janesville, WI 53545-1126
Phone
(608) 757-1217
NPI assigned
Feb 14, 2007
Last updated
Sep 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Authorized official

Name
Deborah JB Gustafson
Title
Manager Patient Accounts
Phone
(608) 364-5123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1321 Creston Park Dr
Janesville, WI 53545-1126

Mailing address

1321 Creston Park Dr
Janesville, WI 53545-1126

Other names 1

  • janesville medical center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000424 WI Part B Supplier - Clinic/Group Practice 8224947858 Receives reassigned benefits from 212 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, WI; Beloit, WI; Darien, WI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 103

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.

View all 103

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1407999337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 CRESTON PARK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 CRESTON PARK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451126",
            "telephone_number": "608-757-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELOIT HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JB",
        "authorized_official_title_or_position": "MANAGER PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "608-364-5123"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "janesville medical center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.