Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

BETHANY MISSIONARY BAPTIST CHURCH
NPI 1164353405
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Ty Ty, GA

Active since May 26, 2026
146 TY TY SYCAMORE RD, TY TY, GA 31795(678) 986-1436 Get Directions Write a Review

NPPES record added: May 26, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bethany Missionary Baptist Church NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETHANY MISSIONARY BAPTIST CHURCH (NPI 1164353405) is a healthcare organization registered as a program of all-inclusive care for the elderly (pace) provider organization in Ty Ty, Georgia and active in the NPI registry since May 2026. The organization lists Samuel Lee Pridgon, Pastor/ceo, as its authorized official.

NPPES Registry Identity

NPI1164353405
Entity TypeOrganization
Primary Taxonomy251T00000X
Legal Business NameBETHANY MISSIONARY BAPTIST CHURCH
Location Address146 TY TY SYCAMORE RDTy Ty, GA 31795-3314
Mailing Address146 Ty Ty Sycamore RdTy Ty, GA 31795-3314 · (678) 986-1436
Organization SubpartNo
Authorized OfficialSamuel Lee PridgonPastor/ceo · (678) 986-1436
Enumeration DateMay 26, 2026
NPPES CertifiedMay 26, 2026
NPI 1164353405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code251T00000X
Definition
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.
146 TY TY SYCAMORE RD, Ty Ty, GA 31795

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bethany Missionary Baptist Church's NPI number?

The NPI number for Bethany Missionary Baptist Church is 1164353405. It was assigned to this organization in the NPPES registry on May 26, 2026.

Where is Bethany Missionary Baptist Church located?

Bethany Missionary Baptist Church is located at 146 Ty Ty Sycamore Rd, Ty Ty, GA 31795. The listed phone number is (678) 986-1436.

What is Bethany Missionary Baptist Church's specialty?

The primary specialty registered for this NPI is Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

When was this NPI record last updated?

The NPPES record for Bethany Missionary Baptist Church was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.