Active NPI
Bethany Reed, CCC-SLP
- Speech-Language Pathologist
- Tupelo, MS
National Provider Identifier
1861047730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S4439
- Practice address
- 90A Clark St
Tupelo, MS 38804-4812 - Phone
- (662) 840-0535
- NPI assigned
- Aug 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S4439 | MS | Primary |
Addresses
Primary practice location
90A Clark St
Tupelo, MS 38804-4812
Mailing address
PO Box 3592
Tupelo, MS 38803-3592
Phone (662) 840-0535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S4439 | MS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-Vista Rehab, Inc | Single Specialty | Past | Accepting new patients |
| Tri-Vista Rehab, Inc. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1861047730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3592",
"city": "TUPELO",
"state": "MS",
"postal_code": "388033592",
"telephone_number": "662-840-0535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90A CLARK ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388044812",
"telephone_number": "662-840-0535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REED",
"first_name": "BETHANY",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-07",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S4439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.