Bluehealth Baptist, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUEHEALTH BAPTIST, LLC

Practice address

401 Baptist Dr Ste 110
Madison, MS 39110-2009

Phone

(601) 664-4300

NPI assigned

Jun 29, 2021

Organization subpart

No

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

Authorized official

Name

Bethany Ungo, RN, MSN, JD

Title

Executive Director

Phone

(601) 664-4545

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1255901591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320339",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392320339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 110",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102009",
            "telephone_number": "601-664-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEHEALTH BAPTIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "UNGO",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-664-4545",
        "authorized_official_credential": "RN, MSN, JD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bespoke Aesthetics and Plastic Surgery
• Arianna Leigh Bierdeman, R.D.
• Takinya Raneese Binion Minor, NP
• Bruce T Black, M.D.
• Jessi Jones Blissett, COTA/L
• Mallory Elizabeth Boggs, A-GNP-C
• Charmaine Bolden
• Kyskie Bolton, RD
• Rachel Roberts Bomgaars, BSN, RN, SNM, SWHNP
• Rachel Bradshaw, PT

• All providers in Madison, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.