# BEACON MEDICAL GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MedPoint Express
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083665673
- **Authorized official:** JEFFREY P. COSTELLO (VP-CFO)
- **Authorized official phone:** (574) 647-3549

## Contact information

- **Practice address:** 926 ERSKINE PLZ, SOUTH BEND, IN 46614-3244
- **Practice address phone:** (800) 635-5516
- **Practice address fax:** (574) 647-6514
- **Mailing address:** 710 N NILES AVE, SOUTH BEND, IN 46617-1924
- **Mailing address phone:** (574) 647-1610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 71000651A | IN | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 08/29/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200130710H | — | IN |
| 05 | — | 200130710I | — | IN |
| 05 | — | 200130710J | — | IN |
| 05 | — | 200130710K | — | IN |