Myrtle Health LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MYRTLE HEALTH LLC

Practice address

623 Broadway
Imperial, NE 69033-3136

Phone

(308) 414-6587

NPI assigned

Mar 28, 2022

Organization subpart

No

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

Authorized official

Name

Deaun Carpenter, NP

Title

Owner

Phone

(308) 414-6587

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1134879547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154",
            "city": "IMPERIAL",
            "state": "NE",
            "postal_code": "690330154",
            "telephone_number": "308-414-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 BROADWAY",
            "city": "IMPERIAL",
            "state": "NE",
            "postal_code": "690333136",
            "telephone_number": "308-414-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "DEAUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-414-6587",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Imperial, NE
• Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.