Individual provider Active NPI

Bethany Metz

  • Family Nurse Practitioner
  • Plymouth, IN
National Provider Identifier
1922806231
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71016626A Issued in IN
Practice address
576 N Oak Dr
Plymouth, IN 46563-1664
Phone
(574) 647-5170
Fax
(574) 647-5183
NPI assigned
Mar 4, 2025
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71016626A IN Primary

Addresses

Primary practice location

576 N Oak Dr
Plymouth, IN 46563-1664

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

1144 W Plymouth St
Bremen, IN 46506-1842
Phone (574) 546-5363

Other identifiers 1

IdentifierTypeStateIssuer
300114759MedicaidIN

Other names 1

  • Bethany Joann Milnickel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626001163 IN Practitioner - Nurse Practitioner 8820500523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

1144 W Plymouth St
Beacon Medical Group Bremen
Bremen, IN 46506-1842
Phone (574) 546-5363

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71016626AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Aug 10, 2025 Accepting new patients
Beacon Medical Group Inc Family CurrentSince Aug 10, 2025 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1144 W Plymouth St
Bremen, IN 46506
Phone (574) 546-5363

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (269) 552-2823

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1922806231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 N OAK DR",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631664",
            "telephone_number": "574-647-5170",
            "fax_number": "574-647-5183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1144 W Plymouth St",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "IN",
            "postal_code": "465061842",
            "country_code": "US",
            "telephone_number": "574-546-5363",
            "fax_number": "574-546-2575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METZ",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-04",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016626A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300114759",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "MILNICKEL",
            "middle_name": "JOANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, IN

Sources for this page

Verify at the official NPI Registry.