Individual provider Active NPI

Carrie Eure, PA-C

  • Physician Assistant
  • Vicksburg, MS
National Provider Identifier
1154789717
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00274 Issued in MS
Practice address
2200 Highway 61 N
Vicksburg, MS 39183-8246
Phone
(601) 883-5940
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00274 MS Primary

Addresses

Primary practice location

2200 Highway 61 N
Vicksburg, MS 39183-8246

Mailing address

2200 Highway 61 N
Vicksburg, MS 39183-8246
Phone (601) 883-5940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carrie.eure.1@1475.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160324000030 MS Practitioner - Physician Assistant 9931406659 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Clinic LLC CurrentSince Apr 1, 2016 Accepting new patients

Locations

104 McAuley Dr
Vicksburg, MS 39183
Phone (601) 638-7271

2200 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-3300

Interoperability endpoints

  • Direct secure messaging: carrie.eure.1@1475.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1154789717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838246",
            "telephone_number": "601-883-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838246",
            "telephone_number": "601-883-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EURE",
        "first_name": "CARRIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carrie.eure.1@1475.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2200 Highway 61 N",
            "city": "Vicksburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391838246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.