Individual provider Active NPI

Kristen Womack, NP-C

  • Family Nurse Practitioner
  • Gloster, MS
National Provider Identifier
1114567617
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903770 Issued in MS
Practice address
434 N Captain Gloster Dr
Gloster, MS 39638-3401
Phone
(601) 225-4711
Fax
(601) 225-4144
NPI assigned
Jan 13, 2020
Last updated
May 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903770 MS Primary

Addresses

Primary practice location

434 N Captain Gloster Dr
Gloster, MS 39638-3401

Mailing address

434 N Captain Gloster Dr
Gloster, MS 39638-3401
Phone (601) 225-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200327000587 MS Practitioner - Nurse Practitioner 1355770231 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Field Memorial Community HospitalGroup PAC ID 0547248544, shared by 7 NPIs, 41 clinicians

Practice addresses (Care Compare)

1334 Arboretum Lane
Gloster, MS 39638

434 N Captain Dr
Gloster, MS 39638
Phone (601) 225-4711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903770MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Field Memorial Community Hospital CurrentSince Feb 26, 2020 Accepting new patients
Field Memorial Community Hospital CurrentSince Feb 26, 2020 Accepting new patients
Field Memorial Community Hospital CurrentSince Feb 26, 2020 Accepting new patients
Field Memorial Community Hospital Family Current Accepting new patients
Field Memorial Community Hospital CurrentSince Sep 4, 2025 Accepting new patients
Field Memorial Community Hospital Current Accepting new patients

Locations

178 Highway 24 E
Centreville, MS 39631
Phone (601) 890-0500

178 Highway 24 E
Ste B
Centreville, MS 39631
Phone (601) 835-0077

434 N Captain Gloster Dr
Gloster, MS 39638
Phone (601) 225-4711

451 Bank St
Woodville, MS 39669
Phone (601) 888-3421

Interoperability endpoints

  • Direct secure messaging: kristen.gordon.1@1773.direct.athenahealth.com
  • Direct secure messaging: kristen.gordon.2@1773.direct.athenahealth.com
  • Direct secure messaging: kristen.gordon.3@1773.direct.athenahealth.com
  • Direct secure messaging: kristen.gordon.4@1773.direct.athenahealth.com

Organizations & group practices 6

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 3

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1114567617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 N CAPTAIN GLOSTER DR",
            "city": "GLOSTER",
            "state": "MS",
            "postal_code": "396383401",
            "telephone_number": "601-225-4711",
            "fax_number": "601-225-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N CAPTAIN GLOSTER DR",
            "city": "GLOSTER",
            "state": "MS",
            "postal_code": "396383401",
            "telephone_number": "601-225-4711",
            "fax_number": "601-225-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "KRISTEN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloster, MS

Sources for this page

Verify at the official NPI Registry.