Kimmie Medina Earley
Individual provider Active NPI Marriage & Family Therapist · Ocean Springs, MS
NPI 1063621183 · NPPES record last updated May 5, 2019
Key facts
- NPI
- 1063621183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- T0509 (MS)
- Practice address
- 6408 Palmetto Pointe Dr
Ocean Springs, MS 39564-8823 - Phone
- (910) 616-9446
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 23, 2026 through Jan 23, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0509 | MS | MD | Marriage & Family Therapist |
| 1342 | NC | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Marriage & Family Therapist | Current | Accepting new patients |
Interoperability endpoints
- kimmieearley@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1342 | NC | |
| Marriage & Family Therapist | 106H00000X | T0509 | MS | Yes |
Addresses
Primary practice location
6408 Palmetto Pointe Dr
Ocean Springs, MS 39564-8823
Mailing address
6408 Palmetto Pointe Dr
Ocean Springs, MS 39564-8823
Phone (910) 616-9446
Other practice location 1
603 S Canal St
Whiteville, NC 28472-4256
Phone (910) 642-3700
Other providers in Ocean Springs, MS
- Devin Duval
- Dva Healthcare Renal Care Inc
- Daniel Bryan Dyess
- Matthew Gregory Dykes
- E Franklin Rawlings, MD
- Mary East
- Kimberly Rose Easterling
- Edgewater Eyecare, Inc
- Bart J. Edmiston Sr.
- Elizabeth E Edmiston
All providers in Ocean Springs, MS · Marriage & Family Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2019. 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.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.