Betty Jo Alexander, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

687693 Issued in MS

Practice address

517 Fifth Ave
Picayune, MS 39466-3203

Phone

(601) 590-1045

Fax

(601) 799-0052

NPI assigned

Feb 14, 2007

Last updated

Jan 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in LA, MS2 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

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Childrens Hospital Medical Practice Corporation

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1821090713

  MS

  Medicare reassignment NPD
• Picayune Pediatrics LLC

  • Preferred Provider Organization
  • Carriere, MS
  • NPI 1891150629
  NPD (past)
• Children's International L.L.C.

  • Pediatrics Physician
  • Slidell, LA
  • NPI 1073620498
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1790828580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 FIFTH AVE",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663203",
            "telephone_number": "601-590-1045",
            "fax_number": "601-798-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 FIFTH AVE",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663203",
            "telephone_number": "601-590-1045",
            "fax_number": "601-799-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "BETTY JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "687693",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "LA",
            "license": "AP03593",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126950",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01808531",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R687693",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Acorn Pediatrics PC
• Acs Emergency Physicians PA
• Roddreka Tarnesha Adams
• Advanced Eyecare, LLC
• Advanced Laparoscopic Associates of Ms PC
• Kaylen Alexander, OT
• Kelvinna McLemore Alexander, NP-C
• James Brian Allen, DPT
• Miranda Lynn Alphonso, PHARMD
• Calie Marie Alsobrooks

• Pediatric Nurse Practitioner in Picayune, MS
• Providers in Picayune, MS by specialty
• Pediatric Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.