# BEP MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942976741
- **Authorized official:** DR. MARCIA A BOCKBRADER JR. MD PHD (OWNER)
- **Authorized official phone:** (614) 286-0305

## Contact information

- **Practice address:** 1505 BETHEL RD, STE 201, COLUMBUS, OH 43220
- **Practice address phone:** (614) 321-9870
- **Practice address fax:** (614) 482-4938
- **Mailing address:** 2749 TRAILWOOD LN, ANN ARBOR, MI 48105
- **Mailing address phone:** (614) 286-0305
- **Mailing address fax:** (614) 482-4938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 2084N0600X | Clinical Neurophysiology Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | — | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | — | — |
| 261QR1100X | Research Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 08/20/2021
- **Last updated:** 07/29/2026