Individual provider Active NPI

Monyetta S Everett, FNP

  • Family Medicine Physician
  • Ridgeland, MS
National Provider Identifier
1861969552
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
903007 Issued in MS
Practice address
270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810
Phone
(662) 429-9111
Fax
(219) 300-5911
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 903007 MS Primary

Addresses

Primary practice location

270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810

Mailing address

1910 Madison Ave # 2638
Memphis, TN 38104-2620
Phone (901) 671-0022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230123000475 TN Practitioner - Nurse Practitioner 5294071767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

6584 Poplar Ave
Suite 406
Memphis, TN 38138-3687
Phone (877) 448-3627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants LLC CurrentSince Nov 7, 2022 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince Nov 7, 2022 Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

3046 Columbia Ave
Ste 208
Franklin, TN 37064

5041 Park Ave
Memphis, TN 38117

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1861969552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 MADISON AVE # 2638",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042620",
            "telephone_number": "901-671-0022",
            "fax_number": "219-300-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 TRACE COLONY PARK DR STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391578810",
            "telephone_number": "662-429-9111",
            "fax_number": "219-300-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "MONYETTA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "903007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.