MR. RAYMOND PATRICK BLYTHE (NPI# 1700210432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700210432 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND PATRICK BLYTHE |
| Credential | CFNP |
| Practice Address |
2080 S Frontage Rd Suite 100 Vicksburg MS 39180-5328 |
| Practice Telephone | 6012621000 |
| Practice Fax Number | 6012621211 |
| Mailing Telephone | 6012621000 |
| Mailing Fax Number | 6012621211 |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R871321 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2080 S FRONTAGE RD SUITE 100 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497710685 | Jeffrey Morris | Internal Medicine | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2006-04-19 |
| 1477915718 | Johanna Kimberl | Physician Assistant | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2016-03-25 |
| 1114387123 | Baleigh Ford | Physician Assistant | 2080 S Frontage Rd, #100, Vicksburg, MS 39180-5328 | 2016-03-03 |
| 1134593361 | Robert C. Clingan, Md, Dermatology | Clinic/Center | 2080 S Frontage Rd, Suite 113, Vicksburg, MS 39180-5328 | 2015-11-27 |
| 1023419801 | Vicksburg Medical Teams Mht LLC | Family Medicine | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2014-09-11 |
| 1508278177 | Medical Associates of Vicksburg Pllc | Internal Medicine | 2080 S Frontage Rd, Vicksburg, MS 39180-5328 | 2014-05-29 |
| 1497188460 | Vicksburg Hma Physician Mgmt | Nurse Practitioner | 2080 S Frontage Rd, Ste 100, Vicksburg, MS 39180-5328 | 2013-08-14 |
| 1720372345 | River Oaks Management Company, LLC | Otolaryngology | 2080 S Frontage Rd, Vicksburg, MS 39180-5328 | 2011-05-31 |
| 1659503878 | Battlefield Compounding Center Incorporated | Pharmacy | 2080 S Frontage Rd, Suite 101a, Vicksburg, MS 39180-5328 | 2009-08-21 |
| 1740412964 | Battlefield Express Drugs Incorporated | Pharmacy | 2080 S Frontage Rd, Suite 101, Vicksburg, MS 39180-5328 | 2009-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144831140 | Manivanh Prudhomme | Nurse Practitioner | 109 Airline Drive, Vicksburg, MS 39180-3918 | 2020-08-12 |
| 1225532450 | Tabitha Nicole Allen | Nurse Practitioner | 2080 S Frontage Rd Ste 106, Vicksburg, MS 39180-5882 | 2018-03-21 |
| 1164971131 | Janine Gibbs Larry | Nurse Practitioner | 139 Watkins Rd, Vicksburg, MS 39180-7291 | 2016-09-30 |
| 1326434564 | Elizabeth Hill | Nurse Practitioner | 4204 Clay St, Vicksburg, MS 39183-3438 | 2015-04-14 |
| 1033522073 | Aubri Bailey Hickman | Nurse Practitioner | 2050 Birdsong Rd, Vicksburg, MS 39183-9200 | 2014-06-07 |
| 1891894101 | Bonnie Lee Morehead | Nurse Practitioner | 204 Duval St, Vicksburg, MS 39183-8207 | 2006-09-22 |
| 1598230245 | Amanda Henson Gill | Nurse Practitioner | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180-5883 | 2018-10-09 |
| 1205343803 | Tonette Harris-haynes | Nurse Practitioner | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2018-01-04 |
| 1881146306 | Kimberly Renee Kilpatrick | Nurse Practitioner | 1907 Mission 66, Vicksburg, MS 39180-3711 | 2016-11-01 |
| 1659739787 | Denesia Y Giffin Pllc | Nurse Practitioner | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2016-02-03 |
| Find all providers in VICKSBURG | ||||
Please comment or provide details below to improve the information on MR. RAYMOND PATRICK BLYTHE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.