Beacon Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BEACON MEDICAL GROUP, INC.

Doing business as

Beacon Medical Group- Buchanan

Practice address

804 E Front St
Buchanan, MI 49107-1444

Phone

(269) 695-3897

Fax

(269) 695-6407

NPI assigned

Jun 23, 2015

Last updated

Sep 20, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

BEACON HEALTH SYSTEM, INC.As reported in NPPES

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

Authorized official

Name

Mr. Jeffrey P. Costello

Title

Cfo

Phone

(574) 647-3549

Specialties & licenses 1

Addresses

Other names 1

• Beacon Medical Group- Buchanan Doing business as

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/28FMw_aQtzSqkrYbQSc2Fss9Rc_nhEOH/

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1487036869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E FRONT ST",
            "city": "BUCHANAN",
            "state": "MI",
            "postal_code": "491071444",
            "telephone_number": "269-695-3897",
            "fax_number": "269-695-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACON HEALTH SYSTEM, INC.",
        "enumeration_date": "2015-06-23",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "574-647-3549",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Medical Group- Buchanan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beverly Ackles
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• Ams Coaching and Consulting
• Ams Coaching and Consulting (Bloom Therapy Group)
• Joyce Gail Bayma-Jilek, D.D.S.
• Corina Sue Beechler, LMT
• Eugene George Benedict, OD
• John Michael Berecz, PH.D.
• Stephanie A Blaylock
• Sharon M Bradley, RN

• Family Medicine Physician in Buchanan, MI
• Providers in Buchanan, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.