Organization Active NPI

Beanstalk Pediatrics, PLLC

  • Pediatrics Physician
  • Ridgeland, MS
National Provider Identifier
1740967520
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BEANSTALK PEDIATRICS, PLLC
Practice address
320 W Jackson St
Ridgeland, MS 39157-2222
Phone
(769) 567-1527
NPI assigned
Jul 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Dr. Constance P Barnes-Woods, MDNPI 1538521901
Title
Owner
Phone
(769) 567-1527

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

320 W Jackson St
Ridgeland, MS 39157-2222

Mailing address

320 W Jackson St
Ridgeland, MS 39157-2222
Phone (769) 567-1527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230718001836 MS Part B Supplier - Clinic/Group Practice 3274993522 Receives reassigned benefits from 1 practitioner
Practice locations: Ridgeland, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2287583Beanstalk Pediatrics PLLC320 W Jackson St, Ridgeland, MS 39157Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory

Locations

320 W Jackson St
Ridgeland, MS 39157
Phone (769) 567-1527

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1740967520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W JACKSON ST",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572222",
            "telephone_number": "769-567-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W JACKSON ST",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572222",
            "telephone_number": "769-567-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEANSTALK PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "BARNES-WOODS",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "769-567-1527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.