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

Organization subpart

No

Name

Kevin Miller, NURSE PRACTITIONERNPI 1588097471

Title

Co Owner

Phone

(662) 348-3342

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

• Kevin Oneal Miller, NP

  • Nurse Practitioner
  • Guntown, MS
  • NPI 1588097471

  MS

  Medicare reassignment Care Compare group NPD Authorized official
• Lori Cleo Harris, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Marietta, MS
  • NPI 1811168578

  MS

  Medicare reassignment Care Compare group NPD
• William Colton Harris, FNP

  • Family Nurse Practitioner
  • Guntown, MS
  • NPI 1386500486

  MS

  Medicare reassignment Care Compare group NPD
• Fulumirani McCoy, NP

  • Family Nurse Practitioner
  • Guntown, MS
  • NPI 1598438483

  MS

  Medicare reassignment Care Compare group NPD
• Ashlyn Elena Stevens, FNP

  • Family Nurse Practitioner
  • Guntown, MS
  • NPI 1306615398

  MS

  Medicare reassignment Care Compare group NPD
• Hannah Grace Reeves, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saltillo, MS
  • NPI 1932737202

  MS

  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)

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

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in MS

Locations

Interoperability endpoints

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 19, 2023.

{
    "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

• All providers in Guntown, MS
• 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.