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Individual provider Active NPI

Betty Diane Edrington, CFNP

  • Family Nurse Practitioner
  • Long Beach, MS
National Provider Identifier
1386720241
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R138400 Issued in MS
Practice address
2 Tower Plaza
Pineville Road
Long Beach, MS 39560
Phone
(228) 575-4374
Fax
(228) 575-4303
NPI assigned
Oct 31, 2006
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R138400 MS Primary
General Practice Registered Nurse 163WG0000X R138400 MS

Addresses

Primary practice location

2 Tower Plaza
Pineville Road
Long Beach, MS 39560

Mailing address

2 Tower Plaza
Pineville Road
Long Beach, MS 39560
Phone (228) 575-4374

Other identifiers 1

IdentifierTypeStateIssuer
05885307MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080818000349 MS Practitioner - Nurse Practitioner 1355416900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1202 Broad Ave
Gulfport, MS 39501-2426
Phone (228) 822-9360

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Garden Park Hospitalist Program LLC Past Accepting new patients

Locations

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Interoperability endpoints

  • Direct secure messaging: bedrington@direct.mhg.com

Organizations & group practices 4

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 62

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

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1386720241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TOWER PLAZA",
            "address_2": "PINEVILLE ROAD",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "39560",
            "telephone_number": "228-575-4374",
            "fax_number": "228-575-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TOWER PLAZA",
            "address_2": "PINEVILLE ROAD",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "39560",
            "telephone_number": "228-575-4374",
            "fax_number": "228-575-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDRINGTON",
        "first_name": "BETTY",
        "middle_name": "DIANE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R138400",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MS",
            "license": "R138400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05885307",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

Verify at the official NPI Registry.