Bettina Rene' Fairley, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

Practice address

2300 Manchester Expy Ste B001
Columbus, GA 31904-6877

Phone

(706) 324-4891

NPI assigned

Apr 1, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1578806220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE B001",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046877",
            "telephone_number": "706-324-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE B001",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046877",
            "telephone_number": "706-324-4891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 General McArthur St",
            "address_purpose": "LOCATION",
            "city": "Moss Point",
            "state": "MS",
            "postal_code": "395635215",
            "country_code": "US",
            "telephone_number": "228-475-2088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "BETTINA",
        "middle_name": "RENE'",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MS",
            "license": "CNM1242",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Lynn Ezell, S/T, MS
• Kingsley Ezema
• Basil Ezenwa, MD
• Alexia D. Faggins
• Carol A. Fair, MED., CCC-SLP
• Trinae Fairris, RBT
• Tamika Fairwell
• Keyvette Faison
• Faith & Harmony Health Care Agency LLC
• Faith & Harmony Health Care Agency LLC

• Advanced Practice Midwife in Columbus, GA
• Providers in Columbus, GA by specialty
• Advanced Practice Midwife in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.