Individual provider Active NPI

Cynthia Lynn Bean

  • Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1003405754
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904340 Issued in MS
Practice address
1203 Jefferson St
Laurel, MS 39440-4354
Phone
(601) 649-2863
NPI assigned
Jan 15, 2021
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904340 MS Primary

Addresses

Primary practice location

1203 Jefferson St
Laurel, MS 39440-4354

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 425-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217001147 MS Practitioner - Nurse Practitioner 4587079975 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

1800 12TH St
Meridian, MS 39301-4158
Phone (601) 484-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904340MSMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rush Medical Foundation Current Accepting new patients
Rush Medical Foundation CurrentSince Feb 1, 2021 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
Rush Medical Foundation CurrentSince Feb 1, 2021 Accepting new patients

Locations

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

1203 Jefferson St
Laurel, MS 39440
Phone (601) 649-2863

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

1800 12th St
Meridian, MS 39301
Phone (601) 483-0011

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1003405754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-425-7550",
            "fax_number": "601-399-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404354",
            "telephone_number": "601-649-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.