Nurse Practitioner House Calls
Organization Active NPI Family Nurse Practitioner · Quitman, MS
NPI 1982115945 · NPPES record last updated Jan 18, 2023
Key facts
- NPI
- 1982115945
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 862287 (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
- Organization subpart
- No
Authorized official
- Name
- Mr. Wendell T Carney
- Title
- FNP
- Phone
- (601) 513-8508
Practitioners 4
-
Jackie E. McHenry II, M.D.
-
Brandi L Robinson, FNP-C
-
Jakob Slusher, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190326001589 | MS | Part B Supplier - Clinic/Group Practice | 6608122494 |
Receives reassigned benefits from 4 practitioners Practice locations: Quitman, MS |
National Provider Directory
Locations
111 Main St
Ste 1
Quitman, MS 39355
111 Main St
Quitman, MS 39355
Phone (601) 557-5105
109 E Donald St
Quitman, MS 39355
Phone (601) 513-8508
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 862287 | MS | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 862287 | Other | MS | MS FNP LICENSE |
Other providers in Quitman, MS
- Mississippi State Department of Health
- Laronda Leshell Moore
- Ms Lakeside LLC
- Randy J Neely
- NP House Calls LLC
- P&P Counseling Services Quitman Branch
- Paratech EMS, Inc.
- Natalie Pearson
- Pensacola Health Trust Inc
- Quitman Drugs LLC
All providers in Quitman, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.