ELLIOTT E. CARTER, MAT, ATC — NPI 1447635719 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in JACKSON, MS)

CMS-1500 Box 24J / 33a • NPI

1447635719

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

261Q00000X (CMS 70)

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

969 LAKELAND DR, JACKSON, MS, 39216-4606

✓ 9-Digit EDI 837 ZIP+4 (39216-4606)

Practice Phone & Referral Fax

(601) 200-2000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1447635719 (ELLIOTT E. CARTER, MAT, ATC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1447635719` (NPI-1 Individual Practitioner)
Provider / Legal Name	ELLIOTT E. CARTER, MAT, ATC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261Q00000X` (Clinic/Center)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	969 LAKELAND DR, JACKSON, MS, 39216-4606
Practice Telephone / Fax	Tel: (601) 200-2000
Administrative Mailing Address	122 NICHOLSON DR, TERRY, MS, 39170-6001
Enumeration & Last Sync	Enumerated: 2015-07-28 \| CMS Record Updated: 2015-07-28

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

969 LAKELAND DR, JACKSON, MS, 39216-4606

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Plain-English Taxonomy & CMS Crosswalk (261Q00000X)

What Does Taxonomy Code 261Q00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261Q00000X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 70 (Clinic or Group Practice)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ELLIOTT E. CARTER, MAT, ATC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261Q00000X` — Clinic/Center Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: MS \| License: `AT0382` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ELLIOTT E. CARTER, MAT, ATC (NPI #1447635719)