Active NPI
New Beginnings
- Specialist
- Carriere, MS
National Provider Identifier
1265630834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- R606391
- Legal business name
- NEW BEGINNINGS
- Practice address
- 79 Pink Smith Rd
Carriere, MS 39426-8641 - Phone
- (601) 749-3887
- NPI assigned
- Jul 5, 2007
- Last updated
- Jul 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carolyn Blythe A. Blythe, PHMNP
- Title
- Provider
- Phone
- (601) 749-3887
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | R606391 | MS | Primary |
Addresses
Primary practice location
79 Pink Smith Rd
Carriere, MS 39426-8641
Mailing address
79 Pink Smith Rd
Carriere, MS 39426-8641
Phone (601) 749-3887
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04007878 | Medicaid | MS | |
| 433667051B | Other | MS | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Carriere, MS
- NPI 1669496915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215734400000",
"number": "1265630834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 PINK SMITH RD",
"city": "CARRIERE",
"state": "MS",
"postal_code": "394268641",
"telephone_number": "601-749-3887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 PINK SMITH RD",
"city": "CARRIERE",
"state": "MS",
"postal_code": "394268641",
"telephone_number": "601-749-3887"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW BEGINNINGS",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-05",
"last_updated": "2008-07-11",
"status": "A",
"authorized_official_last_name": "BLYTHE",
"authorized_official_first_name": "CAROLYN BLYTHE",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "601-749-3887",
"authorized_official_credential": "PHMNP"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MS",
"license": "R606391",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04007878",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "433667051B",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carriere, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.