OrganizationActive
Bethany Missionary Baptist Church
NPI 1164353405 · PACE Provider Organization · Ty Ty, GA
Bethany Missionary Baptist Church is a PACE Provider Organization organization in Ty Ty, GA (NPI 1164353405).
Provider details
- NPI number
- 1164353405
- Entity type
- Organization
- Primary specialty
- PACE Provider OrganizationAgencies
- Organization subpart
- No
- Authorized official
- Samuel Pridgon, Pastor/Ceo(678) 986-1436
Specialties & taxonomies
Agencies
Profile Score
Established profile(52/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
146 Ty Ty Sycamore Rd
Ty Ty, GA 31795-3314
Phone: (678) 986-1436
Approximate (ZIP-level) locationGet directions
Mailing address
146 Ty Ty Sycamore Rd
Ty Ty, GA 31795-3314
Registry dates
- Enumerated
- 2026-05-26
- Last updated
- 2026-05-26
- Certified
- 2026-05-26
Frequently asked questions
- What is Bethany Missionary Baptist Church's NPI number?
- Bethany Missionary Baptist Church's National Provider Identifier (NPI) is 1164353405, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bethany Missionary Baptist Church?
- Bethany Missionary Baptist Church is classified in the NPPES registry as PACE Provider Organization (Agencies).
- Where is Bethany Missionary Baptist Church located?
- Bethany Missionary Baptist Church's practice location on file with NPPES is 146 Ty Ty Sycamore Rd, Ty Ty, GA 31795-3314.
- What is Bethany Missionary Baptist Church's phone number?
- The practice phone number listed in the NPPES registry for Bethany Missionary Baptist Church is (678) 986-1436.
- Who is the authorized official for Bethany Missionary Baptist Church?
- The authorized official listed on Bethany Missionary Baptist Church's NPPES record is Samuel Pridgon, Pastor/Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bethany Missionary Baptist Church's NPI active?
- Yes — Bethany Missionary Baptist Church's NPI (1164353405) is active in the NPPES registry as of the last update on 2026-05-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.