Individual provider Active NPI

Bethany Lee, CRNP

  • Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1669064580
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-102680 Issued in AL
Practice address
735 S Washington Ave
Mobile, AL 36603-1301
Phone
(251) 433-2642
NPI assigned
Feb 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-102680 AL Primary

Addresses

Primary practice location

735 S Washington Ave
Mobile, AL 36603-1301

Mailing address

735 S Washington Ave
Mobile, AL 36603-1301
Phone (251) 433-2642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20211220002044 AL Practitioner - Nurse Practitioner 9739570185 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alabama Post-Acute Medical Service 1 PCGroup PAC ID 7416229406, 17 clinicians
NM Pacs 2 LLCGroup PAC ID 3375892060, 108 clinicians

Practice addresses (Care Compare)

1720 Knowles Rd
Phenix City, AL 36869-7135
Phone (334) 291-0485

857 Crawford LN
Mobile, AL 36617-3877
Phone (251) 476-3420

Hospital & facility affiliations

  • Amedisys Home Health of Foley Home health agency, Foley, AL, CCN 017069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-102680ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NM Pacs 2 LLC CurrentSince Mar 22, 2023 Accepting new patients
Alabama Post-Acute Medical Service 1 PC CurrentSince Mar 22, 2023 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Aug 1, 2024 Accepting new patients
Bay Area Community Medicine, PC CurrentSince Mar 14, 2022 Accepting new patients

Locations

1555 Hillabee St
Alexander City, AL 35010
Phone (256) 329-0847

280 Mt Hebron Rd
Elmore, AL 36025
Phone (334) 265-7585

735 S Washington Ave
Mobile, AL 36603
Phone (251) 433-2642

3737 Government Blvd
Ste 408
Mobile, AL 36693
Phone (251) 602-1911

1720 Knowles Rd
Phenix City, AL 36869
Phone (334) 291-0485

857 Crawford Ln
Prichard, AL 36617
Phone (251) 433-9801

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1669064580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 S WASHINGTON AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366031301",
            "telephone_number": "251-433-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 S WASHINGTON AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366031301",
            "telephone_number": "251-433-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BETHANY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-102680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.