Beacon Health Services LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BEACON HEALTH SERVICES LLC

Doing business as

Beacon Health Sciences

Practice address

802 Old Springfield Ave
Summit, NJ 07901-1130

Phone

(908) 333-4665

NPI assigned

Dec 23, 2019

Last updated

Dec 23, 2019By 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

Dr. Shakthi Kumar, DHA

Title

Founder & Ceo

Phone

(908) 333-4665

Specialties & licenses 3

Addresses

Other names 1

• Beacon Health Sciences Doing business as

Locations

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1609415520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 OLD SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079011130",
            "telephone_number": "908-333-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 OLD SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079011130",
            "telephone_number": "908-333-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "SHAKTHI",
        "authorized_official_title_or_position": "FOUNDER & CEO",
        "authorized_official_telephone_number": "908-333-4665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DHA"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Health Sciences",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Summit, NJ
• Providers in Summit, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.