Kisha L Knight, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Hattiesburg, MS
NPI 1023319936 · NPPES record last updated Apr 1, 2014
Key facts
- NPI
- 1023319936
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R863895 (MS)
- Practice address
- 404 Lillie Burney St
Hattiesburg, MS 39401-5505 - Phone
- (601) 450-6500
- Fax
- (601) 450-6503
- NPI assigned
- Nov 9, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeast Mississippi Rural Health Initiative, Inc.
Practice addresses (Care Compare)
404 Lillie Burney St
Hattiesburg, MS 39401-5505
Phone (601) 450-6500
Hospital & facility affiliations
- Forrest General Home Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110103000006 | MS | Practitioner - Nurse Practitioner | 1456549740 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Central Clinics, Inc | Current |
Accepting new patients | |
| South Central Clinics, Inc | Current |
Accepting new patients | |
| Brooklyn Family Health Center | Current |
Accepting new patients | |
| Hattiesburg Community Dental Center | Current |
Accepting new patients | |
| Sumrall Family Health Center | Current | Accepting new patients | |
| Picayune Family Health Center | Past | Accepting new patients | |
| Hattiesburg Public School and Community Clinic | Past | Accepting new patients | |
| Women'S Health Center | Past | Accepting new patients | |
| N R Burger School and Community Clinic | Past | Accepting new patients | |
| Lumberton Family Health Center | Past | Accepting new patients | |
| Hattiesburg High School and Community Clinic | Past | Accepting new patients | |
| Beaumont Family Health Center | Past | Accepting new patients | |
| Minor Care Clinic | Past | Accepting new patients | |
| Semrhi Mobile Healthcare Unit | Past | Accepting new patients | |
| Lamar County School Clinic | Past | Accepting new patients | |
| New Augusta Family Health Center | Past | Accepting new patients | |
| Petal School Clinic | Past | Accepting new patients | |
| Southeast Mississippi Rural Health Initiative, Inc. | Past | Accepting new patients | |
| Seminary Family Health Center | Past | Accepting new patients |
Locations (25 of 47)
215 Old Highway 49 E
Brooklyn, MS 39425
Phone 60154587002217
44 Brooklyn Janice Rd
Brooklyn, MS 39425
Phone (601) 582-1188
8 Burborne St
Brooklyn, MS 39425
Phone (601) 545-7714
1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553
1760 Old Highway 24
Hattiesburg, MS 39402
Phone (601) 264-6724
2207 W 7th St
Hattiesburg, MS 39401
Phone (601) 450-6500
70 Leaf Ln
Hattiesburg, MS 39402
Phone (601) 264-9764
316 Travillion Rd
Hattiesburg, MS 39401
Phone (601) 584-9303
301 Hutchinson Ave
Hattiesburg, MS 39401
Phone (601) 450-6101
62 Old Airport Rd
Hattiesburg, MS 39401
Phone (601) 544-4550
100 W Front St
Hattiesburg, MS 39401
Phone (601) 270-6968
66 Old Airport Rd
Hattiesburg, MS 39401
Phone (601) 544-7500
605 Stadium Dr
Hattiesburg, MS 39401
Phone (601) 450-0310
693 Eatonville Rd
Hattiesburg, MS 39401
Phone 60125526602217
500 Martin Luther King Ave
Hattiesburg, MS 39401
Phone (601) 583-0960
10 Archie Smith Rd
Hattiesburg, MS 39402
Phone (601) 268-2217
5198 Old Highway 11
Hattiesburg, MS 39402
Phone (601) 264-7232
5279 W 4th St
Hattiesburg, MS 39402
Phone (601) 264-3858
901 Ida Ave
Hattiesburg, MS 39401
Phone (601) 582-5291
702 Eatonville Rd
Hattiesburg, MS 39401
2900 Jamestown Rd
Hattiesburg, MS 39402
Phone (601) 255-2660
404 Lillie Burney St
Hattiesburg, MS 39401
Phone (601) 450-6500
526 Forrest St
Hattiesburg, MS 39401
Phone (601) 583-4311
790 Elks Lake Rd
Hattiesburg, MS 39401
Phone (601) 582-4890
2006 Oferral St
Hattiesburg, MS 39401
Phone (601) 583-8112
Interoperability endpoints
- kknight101545@directpatientrecord.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R863895 | MS | Yes |
Addresses
Primary practice location
404 Lillie Burney St
Hattiesburg, MS 39401-5505
Mailing address
PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-3700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12181296 | Other | MS | CAQH ID NUMBER |
| 9900628 | Other | MS | AETNA |
| 05401590 | Medicaid | MS |
Other names
- Kisha L Waller
Other providers in Hattiesburg, MS
- Amanda Kirtland
- Kja Consulting
- Maria J Knickerbocker
- Jennifer Knight Embrey
- Kathy Knight
- Virginia Claire Kolvites
- Erin Elizabeth Konves
- Jessica Kopf Cornett
- John Herrington Kosko
- Melissa K Kossman
All providers in Hattiesburg, 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 Apr 1, 2014. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.