1. Home
  2. Directory
  3. Indiana
  4. Bristol
  5. Family Medicine
  6. NPI Profile

BEACON MEDICAL GROUP BRISTOL
NPI 1447285697
Family Medicine in Bristol, IN

Active since July 12, 2006CLIA 15D0712697 · Waiver
306 E VISTULA, BRISTOL, IN 46507(574) 848-4427(574) 848-4592 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 27, 2016, Sep 21, 2016 (2 updates tracked since 2016).

About Beacon Medical Group Bristol NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACON MEDICAL GROUP BRISTOL (NPI 1447285697) is a healthcare organization registered as a family medicine in Bristol, Indiana and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 19, 2027 and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1447285697
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address306 E VISTULABristol, IN 46507-9489
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Phone(574) 848-4427
Fax(574) 848-4592
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateJuly 12, 2006
Last NPPES UpdateApril 24, 20232 updates tracked since enumeration
NPPES CertifiedApril 24, 2023
✔ NPI 1447285697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 06-005017-1
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
306 E VISTULA, Bristol, IN 46507
Open in Google Maps ↗

Other Names 1

Doing Business AsBeacon Medical Group Bristol

Other Identifiers 2

Other000000110755IN · Bcbs Remit
Medicaid100114000BIN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D0712697

Beacon Medical Group Bristol · Bristol, IN
Active · expires Feb 19, 2027
CLIA Number15D0712697
Laboratory TypeHealth Main. Organization
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorJustin Grannell
Laboratory Phone(574) 848-4427
Laboratory LocationBeacon Medical Group Bristol306 E Vistula St, Bristol, IN 46507
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTIN GRANNELL DO
Family Medicine
306 E VISTULA
BRISTOL, IN 46507
Elkhart County (574) 848-4427
LISA J FELSMAN MD
Family Medicine
306 E VISTULA
BRISTOL, IN 46507
Elkhart County (574) 848-4427

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beacon Medical Group, Inc.'s NPI number?

The NPI number for Beacon Medical Group, Inc. is 1447285697. It was assigned to this organization in the NPPES registry on July 12, 2006. The provider is doing business as Beacon Medical Group Bristol.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 306 E Vistula, Bristol, IN 46507. The listed phone number is (574) 848-4427.

What is Beacon Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Beacon Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D0712697) is associated with this NPI, valid through February 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beacon Medical Group, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Beacon Medical Group, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Beacon Medical Group, Inc. was last updated on April 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.