Organization Active NPI

Nurse Practitioner House Calls

  • Family Nurse Practitioner
  • Quitman, MS
National Provider Identifier
1982115945
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
862287 Issued in MS
Legal business name
NURSE PRACTITIONER HOUSE CALLS
Practice address
109 E Donald St
Quitman, MS 39355-2310
Phone
(601) 513-8508
Fax
(601) 557-4181
NPI assigned
Oct 18, 2017
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Mr. Wendell T Carney
Title
FNP
Phone
(601) 513-8508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 862287 MS Primary

Addresses

Primary practice location

109 E Donald St
Quitman, MS 39355-2310

Mailing address

PO Box 838
Quitman, MS 39355-0838
Phone (601) 513-8508

Other practice location 1

111 Main St
Quitman, MS 39355-2119
Phone (601) 527-3145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190326001589 MS Part B Supplier - Clinic/Group Practice 6608122494 Receives reassigned benefits from 4 practitioners
Practice locations: Quitman, MS

National Provider Directory

National Provider Directory

Locations

109 E Donald St
Quitman, MS 39355
Phone (601) 513-8508

111 Main St
Quitman, MS 39355
Phone (601) 557-5105

111 Main St
Ste 1
Quitman, MS 39355

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1982115945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 838",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393550838",
            "telephone_number": "601-513-8508",
            "fax_number": "601-557-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E DONALD ST",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552310",
            "telephone_number": "601-513-8508",
            "fax_number": "601-557-4181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Main St",
            "address_purpose": "LOCATION",
            "city": "Quitman",
            "state": "MS",
            "postal_code": "393552119",
            "country_code": "US",
            "telephone_number": "601-527-3145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NURSE PRACTITIONER HOUSE CALLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "CARNEY",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "601-513-8508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "862287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quitman, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.