Bethany Paige Bledsoe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4468 Issued in TN

Practice address

233 Oil Well Rd
Suite C
Jackson, TN 38305-8014

Phone

(731) 660-8467

NPI assigned

Sep 21, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Imind Mental Health and Wellness LLCGroup PAC ID 8426307364, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Imind Mental Health and Wellness LLC

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1144714882
  Medicare reassignment Care Compare group
• Imind Geriatrics and Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, TN
  • NPI 1265174775
  Medicare reassignment NPD
• Professional Health Services of Jackson

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1407951684
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831298587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 LYNWOOD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014235",
            "telephone_number": "731-695-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 OIL WELL RD",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058014",
            "telephone_number": "731-660-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "BETHANY",
        "middle_name": "PAIGE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - TN",
            "identifier": "4138245",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3987481",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jase Blakney, PTA
• Derek Blankenship, PA-C
• Joe David Blankenship, M.D.
• Mary Jo Blanton, FNP
• BLC Jackson Oaks, LLC
• Toni Blocker
• Tyler Blocker, CRNA
• Elizabeth Andrea Blow, RD
• Billie Sue Blythe, CASE MANAGER
• Sandra Bobbitt, CASE MANAGER

• Clinical Social Worker in Jackson, TN
• Providers in Jackson, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.