Bethany Joy Ishmael, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP129637 Issued in TX

Practice address

303 S Highway 78 Ste 106
Wylie, TX 75098-3915

Phone

(972) 801-9689

NPI assigned

Nov 18, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1770957441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S HIGHWAY 78 STE 106",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983915",
            "telephone_number": "972-801-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S HIGHWAY 78 STE 106",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983915",
            "telephone_number": "972-801-9689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3005 Joe Ramsey Blvd E Ste A",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "TX",
            "postal_code": "754017776",
            "country_code": "US",
            "telephone_number": "903-455-4458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISHMAEL",
        "first_name": "BETHANY",
        "middle_name": "JOY",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP129637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Institute of Harmonic Massage
• Integra Psychological Services
• Interventional Partners PLLC
• Mubina Iqbal
• Kyonna Charissa Irby, LMSW
• Amanda Israel
• Ekundayo Oladehinde Israel
• Suzanne Marie James, LCSW
• Jess Allen, M.Ed., Bcba, Inc.
• Gloria Jituboh

• Pediatric Nurse Practitioner in Wylie, TX
• Providers in Wylie, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.