Excel Care

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EXCEL CARE

Practice address

2310 Letitia St
Vicksburg, MS 39180-4138

Phone

(225) 610-5376

Fax

(225) 361-0483

NPI assigned

Jun 30, 2023

Last updated

Jun 30, 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

Mr. Dickson E Idusuyi

Title

Ceo

Phone

(225) 610-5376

Specialties & licenses 1

Addresses

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.

• Renita Prejean

  • Mental Health Counselor
  • Lafayette, LA
  • NPI 1588109920
  NPD

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1538846571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 LETITIA ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804138",
            "telephone_number": "225-610-5376",
            "fax_number": "225-361-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 LETITIA ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804138",
            "telephone_number": "225-610-5376",
            "fax_number": "225-361-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "IDUSUYI",
        "authorized_official_first_name": "DICKSON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-610-5376",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Erickson
• Sheila Erves
• Samonia Lynn Etheridge, LPC
• Carrie Eure, PA-C
• Hope Evans, MS SLP/CCC
• Eyeline Optical of Vicksburg Inc
• John David Fagan, M.D.
• Lisa D Fairchild, MD
• Faith Therapy Practice
• Fast Pace Mississippi, PLLC

• Community/Behavioral Health Agency in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.