Individual provider Active NPI

Kiara Diontea Merchant, NP

  • Family Nurse Practitioner
  • Canton, MS
National Provider Identifier
1124691191
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904301 Issued in MS
Practice address
1171 Hart St
Canton, MS 39046-4805
Phone
(601) 859-9888
NPI assigned
Jul 19, 2021
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904301 MS Primary
Registered Nurse 163W00000X 901425 MS

Addresses

Primary practice location

1171 Hart St
Canton, MS 39046-4805

Mailing address

624 S Second St
Brookhaven, MS 39601-3941
Phone (601) 669-7357

Other practice location 1

1082 Gluckstadt Rd
Gluckstadt, MS 39110-7243
Phone (601) 707-5621

Other practice location 2

2629 Courthouse Cir
Flowood, MS 39232-9521
Phone (601) 420-4300

Other practice location 3

1435 Grand Ave
Yazoo City, MS 39194-2651
Phone (662) 746-3555

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
I20250828002260 MS Practitioner - Nurse Practitioner 0244731602 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PSP Medical Clinic LLCGroup PAC ID 6406859446, 11 clinicians
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

1171 Hart St
Canton, MS 39046-4805
Phone (601) 859-9888

760 Brookway Blvd
Brookhaven, MS 39601-2658
Phone (423) 662-7002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901425MSMDRegistered Nurse
904301MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PSP Medical Clinic Single Specialty CurrentSince Jul 15, 2025 Accepting new patients
PSP Medical Clinic LLC Single Specialty CurrentSince Jul 15, 2025 Accepting new patients
PSP Medical Clinic PastSince Aug 1, 2025 Accepting new patients

Locations

1171 Hart St
Canton, MS 39046
Phone (601) 859-9888

2629 Courthouse Cir
Flowood, MS 39232
Phone (601) 362-0611

1435 Grand Ave
Yazoo City, MS 39194
Phone (662) 532-2399

Interoperability endpoints

  • Direct secure messaging: kiara.merchant.p1@direct.magnoliamedical.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1124691191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S SECOND ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013941",
            "telephone_number": "601-669-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 HART ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464805",
            "telephone_number": "601-859-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1082 Gluckstadt Rd",
            "address_purpose": "LOCATION",
            "city": "Gluckstadt",
            "state": "MS",
            "postal_code": "391107243",
            "country_code": "US",
            "telephone_number": "601-707-5621",
            "fax_number": "601-707-5627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2629 Courthouse Cir",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392329521",
            "country_code": "US",
            "telephone_number": "601-420-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1435 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391942651",
            "country_code": "US",
            "telephone_number": "662-746-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "KIARA",
        "middle_name": "DIONTEA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904301",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "901425",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.