Eudora Medical Center LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

EUDORA MEDICAL CENTER LLC

Practice address

8995 W Commerce St Ste 4
Hernando, MS 38632-6812

Phone

(662) 589-6290

Fax

(662) 649-6085

NPI assigned

Dec 19, 2022

Last updated

Mar 6, 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

Ms. Amy M. Perkins, FNP-CNPI 1487903936

Title

Owner

Phone

(662) 589-6290

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eudora Medical Clinic Other name

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://fhir4.healow.com/fhir/r4/EIJJCD

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.

• Amy M. Perkins, FNP-C

  • Family Nurse Practitioner
  • Hernando, MS
  • NPI 1487903936

  Adult Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1255043493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8995 W COMMERCE ST STE 4",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386326812",
            "telephone_number": "662-589-6290",
            "fax_number": "662-649-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8995 W COMMERCE ST STE 4",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386326812",
            "telephone_number": "662-589-6290",
            "fax_number": "662-649-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUDORA MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-589-6290",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03003882",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS NURSING/NP LICENSE",
            "identifier": "879057",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eudora Medical Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Eudora Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adult Medicine Physician in Hernando, MS
• Providers in Hernando, MS by specialty
• Adult Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.