Macon Overton III, NP

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

1-171815 Issued in AL

Practice address

245 Governors Dr SE
Huntsville, AL 35801-2700

Phone

(256) 265-7946

NPI assigned

Dec 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Chip Overton Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Super Kids Urgent Care, PLLC

  • Pediatrics Physician
  • Owens Cross Roads, AL
  • NPI 1295699635
  NPD Authorized official

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1962974147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 DANIKA DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064119",
            "telephone_number": "601-540-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 GOVERNORS DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358012700",
            "telephone_number": "256-265-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "MACON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "AL",
            "license": "1-171815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIP",
            "last_name": "OVERTON",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katherine D Otto, CRNP
• Lorinda Otto, BCBA-D
• Kay Ballard Ousby, CRNP
• Baelie J Overby, PTA
• Jessica Overcast, RN
• Elisabeth Anne Owen, CRNP
• Linda Jan Owen, ALC
• Ray Owen II, MS
• Alicia Ann Marie Owens, LMFT
• John W Owens, M.D.

• Critical Care Pediatric Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Critical Care Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.