NPIMap

Organization Active NPI

Northstar Healthcare-Beta LLC

  • Family Medicine Physician
  • Ridgeland, MS
National Provider Identifier
1982299012
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHSTAR HEALTHCARE-BETA LLC
Practice address
1060 E County Line Rd Ste 6
Ridgeland, MS 39157-1937
Phone
(601) 438-2678
Fax
(601) 438-2679
NPI assigned
Mar 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Kelsey Blevins
Title
National Director of Operations
Phone
(901) 378-3561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1060 E County Line Rd Ste 6
Ridgeland, MS 39157-1937

Mailing address

1060 E County Line Rd Ste 6
Ridgeland, MS 39157-1937
Phone (601) 438-2678

National Provider Directory

National Provider Directory

Locations

1060 E County Line Rd
Ste 6
Ridgeland, MS 39157
Phone (601) 357-0669

341 E Main St
Ste A1
Tupelo, MS 38804
Phone (662) 680-2636

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1982299012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E COUNTY LINE RD STE 6",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571937",
            "telephone_number": "601-438-2678",
            "fax_number": "601-438-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E COUNTY LINE RD STE 6",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571937",
            "telephone_number": "601-438-2678",
            "fax_number": "601-438-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR HEALTHCARE-BETA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "901-378-3561"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.