BETHANY MEDICAL CLINIC, LLC
NPI 1487792032
Nurse Practitioner - Family in Cleveland, MS

Q: What is Bethany Medical Clinic, LLC's NPI number?

The NPI number for Bethany Medical Clinic, LLC is 1487792032. It was assigned to this organization in the NPPES registry on February 2, 2007.

Q: What is Bethany Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since February 02, 2007

548 EAST ROSEMARY ROAD, SUITE B, CLEVELAND, MS 38732(662) 846-5032(662) 846-5034 Get Directions Write a Review

NPPES record last updated: March 9, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Bethany Medical Clinic, Llc NPPES

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

BETHANY MEDICAL CLINIC, LLC (NPI 1487792032) is a healthcare organization registered as a family in Cleveland, Mississippi and active in the NPI registry since February 2007. The organization lists Ricky Moore, Ins. Clerk, as its authorized official.

NPPES Registry Identity

NPI1487792032

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameBETHANY MEDICAL CLINIC, LLC

Location Address548 EAST ROSEMARY ROAD, SUITE BCleveland, MS 38732

Mailing AddressPo Box 358Cleveland, MS 38732-0358 · (662) 846-5032 · Fax (662) 846-5034

Phone(662) 846-5032

Fax(662) 846-5034

Organization SubpartNo

Authorized OfficialRicky MooreIns. Clerk · (662) 846-5032

Enumeration DateFebruary 2, 2007

Last NPPES UpdateMarch 9, 2010

✔ NPI 1487792032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · R793654

548 EAST ROSEMARY ROAD, Cleveland, MS 38732

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Other Identifiers 2

Medicaid07021837MS

Medicare ID-Type UnspecifiedC03021MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Medical Clinic, LLC's NPI number?

The NPI number for Bethany Medical Clinic, LLC is 1487792032. It was assigned to this organization in the NPPES registry on February 2, 2007.

Where is Bethany Medical Clinic, LLC located?

Bethany Medical Clinic, LLC is located at 548 East Rosemary Road Suite B, Cleveland, MS 38732. The listed phone number is (662) 846-5032.

What is Bethany Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Bethany Medical Clinic, LLC was last updated on March 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.