Mary Katherine Benavidez, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

907261 Issued in MS

Practice address

119 City Market Dr
Saltillo, MS 38866-7002

Phone

(662) 534-0898

Fax

(662) 534-8905

NPI assigned

Jul 15, 2025

Last updated

Aug 10, 2026By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Internal Medicine and Pediatric Clinic of New Albany, PLLC

  dba Internal Medicine and Pediatric Clinic

  • Internal Medicine Physician
  • New Albany, MS
  • NPI 1811073356
  Medicare reassignment NPD
• Internal Medicine and Pediatric Clinic of New Albany, PLLC

  dba Internal Medicine and Pediatric Clinic

  • Internal Medicine Physician
  • Saltillo, MS
  • NPI 1871207456

  Pediatrics

  NPD

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1487545554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 VAN BUREN AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015723",
            "telephone_number": "662-266-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CITY MARKET DR",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388667002",
            "telephone_number": "662-534-0898",
            "fax_number": "662-534-8905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Fairfield Dr",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "MS",
            "postal_code": "386523107",
            "country_code": "US",
            "telephone_number": "662-534-0898",
            "fax_number": "662-534-8905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENAVIDEZ",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "907261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbenavidez715633@direct.bmhcc.org",
            "affiliation": "N",
            "endpointDescription": "EPIC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "119 City Market Dr",
            "city": "Saltillo",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388667002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Saltillo, MS
• Providers in Saltillo, MS by specialty
• Pediatric Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.