Beacon Health Ventures Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

69000135A Issued in IN

Legal business name

BEACON HEALTH VENTURES INC

Practice address

900 I St
La Porte, IN 46350-5533

Phone

(219) 324-1775

NPI assigned

Nov 13, 2006

Last updated

Apr 19, 2018By 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

Jeffery Costello

Title

Cfo

Phone

(574) 647-8545

Specialties & licenses 1

Addresses

Other identifiers 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Specialists Bremen

  • Podiatrist
  • Bremen, IN
  • NPI 1558652347

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1992876627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS ROAD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351780",
            "telephone_number": "574-647-2273",
            "fax_number": "574-647-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 I ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505533",
            "telephone_number": "219-324-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH VENTURES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "574-647-8545"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000135A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER",
            "identifier": "000000363708",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200253800A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barber Mental Health Associates LLC
• Philip Barber
• Gabrielle Lynn Batchelor
• Jacqueline Baumeister, M.ED., ED. S
• Michael J Beach, FNP
• Beacon Medical Group, Inc. (Beacon Medical Group LaPorte)
• Danielle Bealor
• Ahmad Reza Behrouzi, DPT
• Jenna Bellis
• Izabella Bensing

• Durable Medical Equipment & Medical Supplies in La Porte, IN
• Providers in La Porte, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.