Active NPI
Myrtle Health LLC
- Nurse Practitioner
- Imperial, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- MYRTLE HEALTH LLC
- Practice address
- 623 Broadway
Imperial, NE 69033-3136 - Phone
- (308) 414-6587
- NPI assigned
- Mar 28, 2022
- Last updated
- Mar 28, 2022
- Organization subpart
- No
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
623 Broadway
Imperial, NE 69033-3136
Mailing address
PO Box 154
Imperial, NE 69033-0154
Phone (308) 414-6587
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D2128328 | Myrtle Health, LLC | Provider-performed microscopy | Mar 27, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Imperial, NE
- NPI 1750678819
NPI Registry JSON
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": "",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Imperial, NE
Sources for this page
- 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.