New Beginnings
Organization Active NPI Specialist · Carriere, MS
NPI 1265630834 · NPPES record last updated Jul 11, 2008
Key facts
- NPI
- 1265630834
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- R606391 (MS)
- Legal business name
- NEW BEGINNINGS
- Practice address
- 79 Pink Smith Rd
Carriere, MS 39426-8641 - Phone
- (601) 749-3887
- NPI assigned
- Jul 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Carolyn Blythe A. Blythe, PHMNP
- Title
- Provider
- Phone
- (601) 749-3887
Practitioners 2
-
Carolyn Ann Blythe, PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080911000297 | MS | Part B Supplier - Clinic/Group Practice | 0547336760 |
Receives reassigned benefits from 1 practitioner Practice locations: Carriere, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | R606391 | MS | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 433667051B | Other | MS | BLUE CROSS BLUE SHIELD |
| 04007878 | Medicaid | MS |
Other providers in Carriere, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.