Elite Care Family Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

342 Issued in MS

Legal business name

ELITE CARE FAMILY MEDICINE, LLC

Practice address

571 Mitchell St
Ste C
Guntown, MS 38849-8500

Phone

(662) 255-8324

Fax

(662) 348-2772

NPI assigned

Oct 1, 2014

Last updated

Apr 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin Miller, NURSE PRACTITIONERNPI 1588097471

Title

Co Owner

Phone

(662) 348-3342

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12573/brand/1/csg/1/fhir/r4

Practitioners 9

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.

• Kevin Oneal Miller, NP

  • Nurse Practitioner
  • Guntown, MS
  • NPI 1588097471
  Medicare reassignment Care Compare group NPD Authorized official
• Lori Cleo Harris, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Marietta, MS
  • NPI 1811168578
  Medicare reassignment Care Compare group NPD
• William Colton Harris, FNP

  • Family Nurse Practitioner
  • Guntown, MS
  • NPI 1386500486
  Medicare reassignment Care Compare group NPD
• Fulumirani McCoy, NP

  • Family Nurse Practitioner
  • Guntown, MS
  • NPI 1598438483
  Medicare reassignment Care Compare group NPD
• Ashlyn Elena Stevens, FNP

  • Family Nurse Practitioner
  • Saltillo, MS
  • NPI 1306615398
  Medicare reassignment Care Compare group NPD
• Hannah Grace Reeves, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saltillo, MS
  • NPI 1932737202
  Medicare reassignment NPD
• Kelsey Melane Dement

  • Family Nurse Practitioner
  • Caledonia, MS
  • NPI 1720856552
  NPD (past)
• Mallori McBryde

  • Family Nurse Practitioner
  • Tupelo, MS
  • NPI 1801671425
  NPD (past)
• John Ramsey

  • Registered Nurse
  • Guntown, MS
  • NPI 1184523813
  NPD (past)

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1194128306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 MITCHELL ST",
            "address_2": "STE C",
            "city": "GUNTOWN",
            "state": "MS",
            "postal_code": "388498500",
            "telephone_number": "662-348-3342",
            "fax_number": "662-348-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 MITCHELL ST",
            "address_2": "STE C",
            "city": "GUNTOWN",
            "state": "MS",
            "postal_code": "388498500",
            "telephone_number": "662-255-8324",
            "fax_number": "662-348-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CARE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2023-04-19",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "662-348-3342",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adults & Children Medical Clinic
• Christian Bryant, NP-C
• Keri Camp, DC
• Brookelyn Griffin, CRNA
• William Colton Harris, FNP
• Sabrina Latesha Hill Wright
• Rebecca Hill
• Fulumirani McCoy, NP

• Primary Care Clinic/Center in Guntown, MS
• Providers in Guntown, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.