Excellence Concierge Medicine LLC

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

Legal business name

EXCELLENCE CONCIERGE MEDICINE LLC

Practice address

7712 Keri CV
Olive Branch, MS 38654-5049

Phone

(901) 832-6805

NPI assigned

May 10, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Miranda D White, FNPNPI 1427568260

Title

FNP/Ceo

Phone

(901) 832-6805

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Miranda D White, APRN

  • Nurse Practitioner
  • Memphis, TN
  • NPI 1427568260
  NPD Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1124718366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 GOODMAN RD",
            "address_2": "SUITE 4 BOX 298",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "901-832-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7712 KERI CV",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386545049",
            "telephone_number": "901-832-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE CONCIERGE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FNP/CEO",
        "authorized_official_telephone_number": "901-832-6805",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Ellis, PHARM.D.
• Tina Ellis, APRN
• Tina Marie Erber, PT
• Deborah Lynne Evans, PT
• L Gregory Evans, DDS
• Exos Physical Therapy & Sports Medicine, LLC
• Exos Physical Therapy and Sports Medicine, LLC
• Eye Care Surgery Center of Olive Branch,LLC
• Eyedok LLC
• Fab Enterprises LLC

• Community Health Nurse Practitioner in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Community Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.