Beloit Health System Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BELOIT HEALTH SYSTEM INC

Practice address

5605 E Rockton Rd
Roscoe, IL 61073-7601

Phone

(815) 525-4000

NPI assigned

Jun 16, 2021

Last updated

Jul 7, 2023By 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

James F Bird, MBS, CPA

Title

Vice President of Finance/Cfo

Phone

(608) 364-5281

Specialties & licenses 5

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1790353753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY FL 5",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 E ROCKTON RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737601",
            "telephone_number": "815-525-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELOIT HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE/CFO",
        "authorized_official_telephone_number": "608-364-5281",
        "authorized_official_credential": "MBS, CPA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0108X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Uveitis and Ocular Inflammatory Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11014000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391028081003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Erin M Bergren, MS.ED., LCPC, ACS

• Ambulatory Surgical Clinic/Center in Roscoe, IL
• Providers in Roscoe, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.