ELITE CARE FAMILY MEDICINE, LLC (NPI# 1194128306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194128306 |
| Entity Type | Organization |
| Organization Name | ELITE CARE FAMILY MEDICINE, LLC |
| Practice Address |
571 Mitchell St Guntown MS 38849-8500 |
| Practice Telephone | 6622558324 |
| Practice Fax Number | 6623482772 |
| Mailing Telephone | 6623483342 |
| Mailing Fax Number | 6623482772 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2015-02-23 |
| Authorized Official Name | KEVIN MILLER (CO OWNER) |
| Authorized Official Telephone | 6622558324 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
342 | MS | Ambulatory Health Care Facilities |
| Street Address |
571 MITCHELL ST |
| City | GUNTOWN |
| State | MS |
| Zip Code | 38849-8500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811168578 | Lori Cleo Harris | Nurse Practitioner | 571 Mitchell St, Guntown, MS 38849-8500 | 2008-03-20 |
| 1790104297 | Christian Allison | Nurse Practitioner | 571 Mitchell St, Suite C, Guntown, MS 38849-8500 | 2014-04-11 |
| 1588097471 | Kevin Oneal Miller | Nurse Practitioner | 571 Mitchell St, Suite C, Guntown, MS 38849-8500 | 2013-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801968474 | Betty C Thornton | Nurse Practitioner | 571 Mitchell Road, Guntown, MS 38849 | 2006-11-15 |
| 1457533424 | Loretta Jean Smith | Nurse Practitioner | 571 Mitchell Road, Guntown, MS 38849 | 2007-12-03 |
| 1326186826 | Adults & Children Medical Clinic | Nurse Practitioner | 571 Mitchell Rd, Suite C, Guntown, MS 38849-0156 | 2007-02-05 |
| 1538409511 | Brenda Sensing | Nurse Practitioner | 571 Mitchell Road, Guntown, MS 38849-5504 | 2013-02-27 |
| 1790993517 | Mary Katherine Oglesby | Speech-Language Pathologist | 1079 County Road 176, Guntown, MS 38849-8521 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790993517 | Mary Katherine Oglesby | Speech-Language Pathologist | 1079 County Road 176, Guntown, MS 38849-8521 | 2007-05-18 |
| 1326186826 | Adults & Children Medical Clinic | Nurse Practitioner | 571 Mitchell Rd, Suite C, Guntown, MS 38849-0156 | 2007-02-05 |
| 1801968474 | Betty C Thornton | Nurse Practitioner | 571 Mitchell Road, Guntown, MS 38849 | 2006-11-15 |
| 1538409511 | Brenda Sensing | Nurse Practitioner | 571 Mitchell Road, Guntown, MS 38849-5504 | 2013-02-27 |
| 1457533424 | Loretta Jean Smith | Nurse Practitioner | 571 Mitchell Road, Guntown, MS 38849 | 2007-12-03 |
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
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| 1134759780 | Family First Clinic of Hernando, Limited | Clinic/Center | 2416 Mount Pleasant Rd, Hernando, MS 38632-2001 | 2020-01-23 |
| 1720640899 | Home In The Woods Healthcare Clinic, LLC | Clinic/Center | 6572 County Road 514, Itta Bena, MS 38941-2746 | 2019-06-28 |
| 1366003436 | Blackwell's Family Medicine LLC | Clinic/Center | 107 Ball Ave, Tylertown, MS 39667-2101 | 2019-06-27 |
| 1710545488 | Primary and Behavioral Healthcare Services, Pa | Clinic/Center | 717 E. Fortification St., Jackson, MS 39202-2402 | 2019-05-29 |
| 1720559354 | Golden Years Geriatrics Inc. | Clinic/Center | 1233 County Road 108, New Albany, MS 38652-9787 | 2018-12-07 |
| 1316421373 | Children's International, LLC | Clinic/Center | 2003 Wildwood Rd, Picayune, MS 39466-2178 | 2018-09-17 |
| 1124505912 | Thaxton Family Medical Clinic LLC | Clinic/Center | 11145 Highway 6 W, Thaxton, MS 38871-9024 | 2018-07-24 |
| 1316439615 | Quad/med, LLC | Clinic/Center | 1000 Jere St. Pe' Hwy, C/o Ingalls Main Substation, 1st Floor, Pascagoula, MS 39567 | 2018-06-01 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
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| 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.