Rebecca Ann Rayborn, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905970 Issued in MS

Practice address

120 E Myrtle St
Magnolia, MS 39652-2834

Phone

(601) 869-7330

Fax

(601) 783-5812

NPI assigned

Apr 18, 2023

Last updated

Jan 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Medicare reassignment Care Compare group NPD
• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  Medicare reassignment Care Compare group NPD
• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738
  Medicare reassignment NPD
• Louisiana Health Care Practitioners LLC

  dba Mansura Family Clinic

  • Rural Health Clinic/Center
  • Mansura, LA
  • NPI 1811065220
  Medicare reassignment
• Minor Med Care, LLC

  • Rural Health Clinic/Center
  • Raymond, MS
  • NPI 1669575627
  NPD
• Freedom Hospital of Magnolia LLC

  dba Frye Magnolia Clinic

  • Rural Health Clinic/Center
  • Magnolia, MS
  • NPI 1235686130
  NPD (past)

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1710674155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 DEERFIELD",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396668124",
            "telephone_number": "601-869-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E MYRTLE ST",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "396522834",
            "telephone_number": "601-869-7330",
            "fax_number": "601-783-5812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Katherine Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392329588",
            "country_code": "US",
            "telephone_number": "601-665-4162",
            "fax_number": "888-398-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYBORN",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Barret Martin, D.M.D.
• Jessica Rene' Mason, FNP-BC
• Mississippi State Department of Health (Southwest Home Health Agency 7C)
• Lindsey Joan Nobles, FNP-C
• Sharee Nobles, NP
• Renew Hope Transition Living, Inc.
• Tamelia Robinson, LPTA
• Rose Hill Missionary Baptist Church (Compassionate Hearts Adult Center)
• Rose Hill Transportation
• Sharael Royal

• Psychiatric/Mental Health Nurse Practitioner in Magnolia, MS
• Providers in Magnolia, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.