Baylee Richardson, PA-C

Individual provider Active NPI Family Medicine Physician · Belzoni, MS

NPI 1881392199 · NPPES record last updated Feb 16, 2023

Key facts

NPI
1881392199
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
PA00703 (MS)
Practice address
107 Church St
Belzoni, MS 39038-3929
Phone
(662) 247-2105
Fax
(662) 247-4849
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Gorton Rural Health Clinic (4 clinicians)
Gorton Lab and X-Ray, LLC (4 clinicians)

Practice addresses (Care Compare)

107 Church St
Belzoni, MS 39038-3929
Phone (662) 247-2105

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230711002360 MS Practitioner - Physician Assistant 9335508167 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gorton Rural Health Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA00703 MS Yes

Addresses

Primary practice location

107 Church St
Belzoni, MS 39038-3929

Mailing address

1362 Lake Washington Rd E
Glen Allan, MS 38744-9748
Phone (601) 405-9047

Other providers in Belzoni, MS

All providers in Belzoni, MS · Family Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.