Raymond Patrick Blythe, CFNP
Individual provider Active NPI Family Nurse Practitioner · Pascagoula, MS
NPI 1700210432 · NPPES record last updated May 20, 2022
Key facts
- NPI
- 1700210432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R871321 (MS)
- Practice address
- 2809 Denny Ave
Pascagoula, MS 39581-5301 - Phone
- (228) 809-5510
- Fax
- (228) 809-5519
- NPI assigned
- Aug 29, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 63
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Singing River Gulfport
Practice addresses (Care Compare)
15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7112
350 Cowan Rd
Gulfport, MS 39507-2008
Phone (228) 206-7054
Hospital & facility affiliations
- Singing River Gulfport
- Memorial Hospital at Gulfport
- Singing River Health System
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 |
|---|---|---|---|---|
| I20140515001570 | MS | Practitioner - Nurse Practitioner | 3577786706 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R871321 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care Doc LLC | Current |
Accepting new patients | |
| Caredoc LLC | Current |
Accepting new patients | |
| Keystone Medical Services of Ms, Inc | Current |
Accepting new patients | |
| Singing River Health System | Current |
Accepting new patients | |
| Singing River Health System | Current |
Accepting new patients | |
| Singing River Gulfport | Current |
Accepting new patients | |
| Memorial Hospital at Gulfport | Nurse Practitioner | Current |
Accepting new patients |
| Coast Heart Institute, PLLC | Current |
Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Past | Accepting new patients |
Locations
1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303
2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576
350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054
4500 13th St
Ste 900
Gulfport, MS 39501
Phone (228) 236-3872
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000
1203 Broad Ave
Gulfport, MS 39501
Phone (228) 547-8814
4215 15th St
Gulfport, MS 39501
Phone (228) 863-5211
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100
1199 Ocean Springs Rd
Ocean Springs, MS 39564
Phone (228) 875-9363
2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000
100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R871321 | MS | |
| Family Nurse Practitioner | 363LF0000X | R871321 | MS | Yes |
Addresses
Primary practice location
2809 Denny Ave
Pascagoula, MS 39581-5301
Mailing address
2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-7576
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01680060 | Medicaid | MS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rblythe@direct.mysrhs.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | rblythe@direct.mysrhs.com | Health Information Exchange (HIE) |
Other providers in Pascagoula, MS
- Kayla Julaine Bird
- Arthur Dewayne Black
- Emilia Blackwell
- Demari Blakely
- Blue Heron Speech Therapy, PLLC
- Erin Hakim Bohner
- Katherine Harlan Bolding
- Hannah Olivia Booker
- Ada Ruth Bosarge
- Donna Sue Bosco
All providers in Pascagoula, MS · Family 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 May 20, 2022. 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.