Individual provider Active NPI

Margaret Faye Paetz, CPNP

  • Pediatric Nurse Practitioner
  • Moss Point, MS
National Provider Identifier
1891187431
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R865490 Issued in MS
Practice address
5605 Highway 614 # B
Moss Point, MS 39562-7569
Phone
(228) 273-0400
Fax
(228) 333-0759
NPI assigned
Feb 18, 2015
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R865490 MS Primary

Addresses

Primary practice location

5605 Highway 614 # B
Moss Point, MS 39562-7569

Mailing address

5605 Highway 614 # B
Moss Point, MS 39562-7569
Phone (228) 273-0400

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
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R865490MSMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Pediatrics Pediatrics CurrentSince Sep 5, 2023 Accepting new patients

Locations

5605 Highway 614
#B
Moss Point, MS 39562
Phone (228) 273-0400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1891187431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 HIGHWAY 614 # B",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395627569",
            "telephone_number": "228-273-0400",
            "fax_number": "228-333-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 HIGHWAY 614 # B",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395627569",
            "telephone_number": "228-273-0400",
            "fax_number": "228-333-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAETZ",
        "first_name": "MARGARET",
        "middle_name": "FAYE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R865490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moss Point, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.