Individual provider Active NPI

Bethany Christine Nile, FNP-C

  • Pediatrics Physician
  • Jesup, GA
National Provider Identifier
1396475950
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
F06220304 Issued in GA
Practice address
391 Peachtree St
Jesup, GA 31545-0245
Phone
(912) 530-7337
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X F06220304 GA Primary

Addresses

Primary practice location

391 Peachtree St
Jesup, GA 31545-0245

Mailing address

391 Peachtree St
Jesup, GA 31545-0245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F06220304GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Pediatrics Pediatrics Past Accepting new patients
Stanley D. Jones, M.D.P.C. Pediatrics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1396475950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450245",
            "telephone_number": "912-530-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILE",
        "first_name": "BETHANY",
        "middle_name": "CHRISTINE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "F06220304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.