Mary Katherine Benavidez, CPNP-PC
Individual provider Active NPI Pediatric Nurse Practitioner · Saltillo, MS
NPI 1487545554 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1487545554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 907261 (MS)
- Practice address
- 119 City Market Dr
Saltillo, MS 38866-7002 - Phone
- (662) 534-0898
- Fax
- (662) 534-8905
- NPI assigned
- Jul 15, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
118 Fairfield Dr
New Albany, MS 38652-3107
1403 Van Buren Ave
Tupelo, MS 38801-5723
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260114002092 | MS | Practitioner - Nurse Practitioner | 9032695556 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 907261 | MS | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Internal Medicine and Pediatric Clinic of New Albany, PLLC | Pediatrics | Current |
Accepting new patients |
| Internal Medicine and Pediatric Clinic of New Albany, PLLC | Current |
Accepting new patients |
Locations
118 Fairfield Dr
New Albany, MS 38652
Phone (662) 534-0898
119 City Market Dr
Saltillo, MS 38866
Phone (662) 534-0898
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 907261 | MS | Yes |
Addresses
Primary practice location
119 City Market Dr
Saltillo, MS 38866-7002
Mailing address
1403 Van Buren Ave
Tupelo, MS 38801-5723
Phone (662) 266-4553
Other practice location 1
118 Fairfield Dr
New Albany, MS 38652-3107
Phone (662) 534-0898
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbenavidez715633@direct.bmhcc.org | Health Information Exchange (HIE) |
Other providers in Saltillo, MS
- Miles Backstrom
- Dana Tate Bailey
- Barnes Crossing Retirement Community LLC
- Dawn Turman Bean
- David Walden Bell
- Shuya Bi
- Bolton Family Medical Clinic, P.C.
- Kirsten J Bolton
- Joshua Edwin Bostick
- Mary Jennings Bouchillon
All providers in Saltillo, MS · Pediatric Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2026. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.