Provider Demographics
NPI:1568421675
Name:MCCARTER, CAREY (NP)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AMITY LN
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-7941
Mailing Address - Country:US
Mailing Address - Phone:601-206-0901
Mailing Address - Fax:888-240-6288
Practice Address - Street 1:AURORA HEALTH AND REHABILITATION
Practice Address - Street 2:310 EMERALD DR
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702
Practice Address - Country:US
Practice Address - Phone:601-206-0901
Practice Address - Fax:888-240-6288
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR851034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05508322Medicaid
MS05508322Medicaid
MS500001562Medicare ID - Type Unspecified