Family Care of Evergreen, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R713511 Issued in MS

Legal business name

FAMILY CARE OF EVERGREEN, LLC

Practice address

4929 Highway 371 S
Nettleton, MS 38858-6901

Phone

(662) 963-9154

Fax

(662) 963-9157

NPI assigned

Sep 22, 2014

Last updated

Sep 22, 2014By 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

Janet Earnest

Title

Office Manager

Phone

(662) 842-4877

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1841692852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "PLANTERSVILLE",
            "state": "MS",
            "postal_code": "388620189",
            "telephone_number": "662-963-9154",
            "fax_number": "662-963-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 HIGHWAY 371 S",
            "city": "NETTLETON",
            "state": "MS",
            "postal_code": "388586901",
            "telephone_number": "662-963-9154",
            "fax_number": "662-963-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE OF EVERGREEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "EARNEST",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-842-4877"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R713511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Castleberry, P.T.
• Shelithea Darden, CPHT
• Katherine Elizabeth Davis, FNP-C
• Evergreen Clini
• Evergreen Family Medical Clinic Inc
• Grace Therapy LLC
• Adam Mitchell Guntharp, DO
• John T Hall, RPH
• Bill Randle Hester, D.C.
• Home Town Market Inc.

• Nurse Practitioner in Nettleton, MS
• Providers in Nettleton, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.