Individual provider Active NPI

Cynethia Lashonda Mae Bethel-Hines, APRN

  • Pediatric Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1669785465
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3006459 Issued in KY
Practice address
234 Amy Ave
Louisville, KY 40212-2522
Phone
(502) 778-0001
NPI assigned
Jul 21, 2010
Last updated
Oct 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3006459 KY Primary

Addresses

Primary practice location

234 Amy Ave
Louisville, KY 40212-2522

Mailing address

234 Amy Ave
Louisville, KY 40212-2522
Phone (502) 778-0001

Other names 1

  • Mrs. Cynethia Lashonda Mae Bethel-Jaiteh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20130717000420 KY Practitioner - Nurse Practitioner 2668612516 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3006459KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Christian Healthcare Center Inc CurrentSince Aug 1, 2022 Accepting new patients
Shawnee Christian Healthcare Center Inc Pediatrics CurrentSince Aug 1, 2022 Accepting new patients

Locations

234 Amy Ave
Louisville, KY 40212
Phone (502) 778-0001

Interoperability endpoints

  • Direct secure messaging: cynethia.bethelhines.p1@direct.shawneechc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1669785465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 AMY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402122522",
            "telephone_number": "502-778-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 AMY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402122522",
            "telephone_number": "502-778-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEL-HINES",
        "first_name": "CYNETHIA",
        "middle_name": "LASHONDA MAE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3006459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNETHIA",
            "last_name": "BETHEL-JAITEH",
            "middle_name": "LASHONDA MAE",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.