NPIMap

Individual provider Active NPI

Kayla McCormick, FNP

  • Family Medicine Physician
  • Winona, MS
National Provider Identifier
1053982900
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
904725 Issued in MS
Practice address
707 Alberta Dr
Winona, MS 38967-1597
Phone
(662) 283-3655
NPI assigned
Jul 1, 2021
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 904725 MS Primary

Addresses

Primary practice location

707 Alberta Dr
Winona, MS 38967-1597

Mailing address

2385 County Road 213
Grenada, MS 38901-6634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220302001762 MS Practitioner - Nurse Practitioner 6103210471 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, shared by 23 NPIs, 956 clinicians

Practice addresses (Care Compare)

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904725MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ms State Department of Health CurrentSince Feb 16, 2022 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Oct 2, 2023 Accepting new patients
Mississippi State Department of Health Current Accepting new patients
Ms State Dept of Health CurrentSince Feb 16, 2022 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Oct 2, 2023 Accepting new patients
State of Mississippi-University of Mississippi Medical Center Family Medicine CurrentSince Dec 30, 2023 Accepting new patients
Mississippi State Department of Health PastSince Jul 31, 2022 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

570 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 576-7345

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: kmccormick187717@ummc.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1053982900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 COUNTY ROAD 213",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389016634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 ALBERTA DR",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389671597",
            "telephone_number": "662-283-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "KAYLA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "904725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MS

Sources for this page

Verify at the official NPI Registry.