Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beacon Medical Group, Inc

Organization Adult Health Nurse Practitioner · NPI 1518302264

Beacon Medical Group, Inc is an Adult Health Nurse Practitioner in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2013.

Licensed in
IN
In the registry since
2013
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

621 Memorial Dr Ste 602
South Bend, IN 46601-1063
Phone: (574) 647-7413
Fax: (574) 647-2471
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 71001587A (IN)

Record details

NPI number1518302264
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Cfo · (574) 647-3549
Other names Memorial Pain Management
NPI enumeratedMay 8, 2013
Last updated in NPPESAugust 30, 2016
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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