Forever Young Mens Health Clinic PLLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

FOREVER YOUNG MENS HEALTH CLINIC PLLC

Practice address

8837 Lorraine Rd Ste B
Gulfport, MS 39503-5042

Phone

(228) 669-7293

NPI assigned

Mar 22, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kendrick McCarty, FNPNPI 1649621368

Title

Owner

Phone

(228) 669-7293

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendrick R McCarty

  • Family Nurse Practitioner
  • Pascagoula, MS
  • NPI 1649621368
  Medicare reassignment NPD Authorized official
• Jared J Deloach II, NP

  • Nurse Practitioner
  • Gulfport, MS
  • NPI 1235766304
  Medicare reassignment NPD
• Kimberly Irby Dominique, FNP

  • Family Nurse Practitioner
  • Pascagoula, MS
  • NPI 1902496524
  Medicare reassignment NPD
• Leland H Elchos, DC

  • Chiropractor
  • Pass Christian, MS
  • NPI 1225841091
  NPD
• Dalton Ray Howe, DC

  • Chiropractor
  • Gulfport, MS
  • NPI 1578270211

  Single Specialty

  NPD
• Brandon Hardin, D.C.

  • Chiropractor
  • Gulfport, MS
  • NPI 1083042170
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1114503190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8837 LORRAINE RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395035042",
            "telephone_number": "228-669-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8837 LORRAINE RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395035042",
            "telephone_number": "228-669-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG MENS HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "MCCARTY",
        "authorized_official_first_name": "KENDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-669-7293",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Foreveryoung21@protonmail.com",
            "affiliation": "N",
            "address_1": "8837 Lorraine Rd Ste B",
            "city": "Gulfport",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395035042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ariel Nicole Fore
• Nicholas Embey Fore
• Macey Darlene Forehand, D.P.T.
• Shelley S Foreman, LPC
• Brian H Foresman, D.O.
• Caleb Fortenberry, DC
• Helen Fosmire, MD
• Paulette L. Foster-Galbraith, M.D.
• Jennifer Montet Foster, FNP-C
• Four Sisters LLC

• Endocrinology, Diabetes & Metabolism Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Endocrinology, Diabetes & Metabolism Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.