Look up the most recent NPI and PECOS records

Beacon Medical Llc

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

45 Industrial Blvd Ste C, Pensacola, FL 32503-7668

PECOS Enrollment

Based on the most recent information from CMS, provider Beacon Medical Llc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1518468966
Provider Type
Organization
Full Name
Beacon Medical Llc

Subpart
No
Enumeration Date
2/21/2018
Last Updated
6/23/2023

Contact Information

Practice Location

45 Industrial Blvd Ste C, Pensacola, FL 32503-7668

(850) 290-8410

(866) 574-6391

Mailing Location

45 Industrial Blvd Ste C, Pensacola, FL 32503-7668

(850) 290-8410

(866) 574-6391

Authorized Official

Jackson, Karen (Owner)

(850) 290-8410

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer
Code 363LA2200X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Beacon Medical Llc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Tolbert, Sean Ashley

Oyugi-Summers, Felix J

Westmark, Alexis Clare

Gordon, Kaleigh

Christy, Delana Alexis

Kasianov, Pavel

Velez, Aubri Rihan

Gates, Jill

Schryver, Kristy Marie

Chastain, Amy