Bethany Johnson Nemati, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

LL82798 Issued in SC

Practice address

506 Harley St
Scottsboro, AL 35768-4219

Phone

(256) 259-1234

Fax

(256) 259-6838

NPI assigned

Jun 10, 2019

Last updated

Dec 5, 2022By 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 1

Other names 1

• Dr. Bethany Lynne Johnson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Horizon Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • Oneonta, AL
  • NPI 1588904791
  Medicare reassignment NPD
• Premier Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • Scottsboro, AL
  • NPI 1083955173
  Medicare reassignment NPD
• Valley Head Clinic LLC

  • Clinic/Center
  • Fort Payne, AL
  • NPI 1790004836
  Medicare reassignment NPD
• Valley Medical Clinic LLC

  • Rural Health Clinic/Center
  • Scottsboro, AL
  • NPI 1063948891
  Medicare reassignment NPD
• Valley Head Clinic LLC

  dba Pisgah Medical Clinic

  • Multi-Specialty Clinic/Center
  • Pisgah, AL
  • NPI 1679827497
  NPD

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1841859287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 HARLEY ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684219",
            "telephone_number": "256-259-1234",
            "fax_number": "562-596-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 HARLEY ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684219",
            "telephone_number": "256-259-1234",
            "fax_number": "256-259-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMATI",
        "first_name": "BETHANY",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "44085",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL82798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083955173",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://premiermdclinic.com/",
            "affiliation": "N",
            "address_1": "506 Harley St",
            "city": "Scottsboro",
            "state": "AL",
            "country_code": "US",
            "postal_code": "357684219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "JOHNSON",
            "middle_name": "LYNNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• MTN Lake Urology PC
• Muhammad Ejaz Ata (Scottsboro Medical Clinic)
• Muhammad Ejaz Ata, M.D (Pisgah Medical Clinic Scottsboro Medical Clinic Muhammad Ejaz Ata MD)
• James Edward Murphree Jr., MS
• Amanda Necklaus, LMT
• Melissa Fay Nevitt, CRNP
• New Beacon Healthcare Group, LLC (New Beacon of Scottsboro)
• North Alabama Eye Care P.C.
• Northeast Alabama Health Services, Inc
• Northeast Alabama Health Services, Inc. (Northeast Alabama Health Services Inc- Skyline)

• Pediatrics Physician in Scottsboro, AL
• Providers in Scottsboro, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.