Active NPI
Antonio Lakendrick Cortez McBeth, RN
- Nurse Practitioner
- Jackson, MS
National Provider Identifier
1790567378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 907859
- Practice address
- 1225 N State St
Jackson, MS 39202-2064 - Phone
- (601) 968-1000
- NPI assigned
- Oct 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 910807 | MS | |
| Nurse Practitioner | 363L00000X | 907859 | MS | Primary |
Addresses
Primary practice location
1225 N State St
Jackson, MS 39202-2064
Mailing address
577 Storm Storm Rd.
Lena, MS 39094
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-4000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 910807 | MS | MD | Registered Nurse |
| 907859 | MS | MD | Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Southaven, MS
- NPI 1801683008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767139200000",
"number": "1790567378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "577 STORM STORM RD.",
"city": "LENA",
"state": "MS",
"postal_code": "39094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022064",
"telephone_number": "601-968-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBETH",
"first_name": "ANTONIO",
"middle_name": "LAKENDRICK CORTEZ",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-18",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MS",
"license": "910807",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "907859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.