Bethany Ann South, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

831 Issued in MS

Practice address

16 South 16TH St
Bay Springs, MS 39422

Phone

(601) 764-2120

Fax

(601) 764-3410

NPI assigned

Jul 30, 2007

Last updated

Jan 12, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bay Springs Eye Care LLC

  • Optometrist
  • Bay Springs, MS
  • NPI 1760790778
  NPD (past)
• Taylorsville Eye Care LLC

  • Optometrist
  • Taylorsville, MS
  • NPI 1326394677
  NPD (past)

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1316137052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394220728",
            "telephone_number": "601-764-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SOUTH 16TH ST",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "39422",
            "telephone_number": "601-764-2120",
            "fax_number": "601-764-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "BETHANY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13338",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "831",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF OPTOM",
            "identifier": "13338",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raleigh Family Health Clinic PLLC (Deloach Family Clinic)
• Region Ten Commission on Mental Health (Weems Mental Health)
• Sarah Russell, FNP-C
• Lelia Marie Simpson, FNP-C
• Baley Smith, FNP
• Standard Marketing Inc (Standard Drug Store)
• Melinda Thigpen, DEM
• James T Tuminello, PTA
• West Jasper Consolidated School District
• Darius Williams

• Optometrist in Bay Springs, MS
• Providers in Bay Springs, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.