Beacon Wellness Solutions LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BEACON WELLNESS SOLUTIONS LLC

Doing business as

Beacon Wellness and Psychiatry

Practice address

101 Lewis St Ste 2
Petoskey, MI 49770

Phone

(231) 881-8838

Fax

(231) 622-8037

NPI assigned

Jan 19, 2022

Last updated

Oct 24, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

BEACON WELLNESS SOLUTIONS LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Karolyn Wilder, PMHNP-BCNPI 1518621994

Title

Provider/Member

Phone

(231) 881-8838

Specialties & licenses 1

Addresses

Other names 1

• Beacon Wellness and Psychiatry Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

Beacon Wellness Solutions LLC

Locations

Practitioners 2

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.

• Karolyn Angela Wilder, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Petoskey, MI
  • NPI 1518621994

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Aaron Charles Greene, P.A.

  • Physician Assistant
  • Petoskey, MI
  • NPI 1598902314
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1689326837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LEWIS ST STE 2",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-881-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LEWIS ST STE 2",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-881-8838",
            "fax_number": "231-622-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACON WELLNESS SOLUTIONS LLC",
        "enumeration_date": "2022-01-19",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "KAROLYN",
        "authorized_official_title_or_position": "PROVIDER/MEMBER",
        "authorized_official_telephone_number": "231-881-8838",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "beaconwellnesssolutions@gmail.com",
            "affiliation": "N",
            "address_1": "101 Lewis St Ste 2",
            "city": "Petoskey",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Beacon Wellness and Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Wellness and Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.