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

Beacon Medical Group, Inc

Organization Family Medicine Physician · NPI 1609828946

Beacon Medical Group, Inc is a Family Medicine Physician in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
Specialties on file
2
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

714 N Michigan St
South Bend, IN 46601-1035
Phone: (574) 647-7477
Fax: (574) 647-3655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01034518A (IN)
Obstetrics & Gynecology Physician Taxonomy 207V00000X

Record details

NPI number1609828946
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vp-Cfo · (574) 647-3549
Other names Beacon Medical Group E. Blair Warner; Beacon Medical Group E. Blair Warner
NPI enumeratedMay 16, 2006
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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