Cassandra L Kingston, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

902595 Issued in MS

Practice address

557 Grants Ferry Rd
Brandon, MS 39047-9023

Phone

(601) 665-4162

Fax

(855) 830-3484

NPI assigned

Jun 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Positive Pathways, LLCGroup PAC ID 0648678425, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Positive Pathways, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vicksburg, MS
  • NPI 1801335492
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1144714353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 GRANTS FERRY RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390479023",
            "telephone_number": "601-665-4162",
            "fax_number": "855-830-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 GRANTS FERRY RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390479023",
            "telephone_number": "601-665-4162",
            "fax_number": "855-830-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "341 Edgewood Terrace Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392066217",
            "country_code": "US",
            "telephone_number": "601-487-6344",
            "fax_number": "601-398-0289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINGSTON",
        "first_name": "CASSANDRA",
        "middle_name": "L",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinetic Play Therapy Services, LLC
• Jennifer Kristin King Lang, PT
• Sharron Elaine King
• Tammy Ciaccio Kingery, RDN
• Holly Marie Kinget, M.D.
• Tashina Kinler, RNFA
• John Sharp Kirk, P-CMHT
• Leslie Kirk
• Kroger Limited Partnership I
• Kroger Limited Partnership I

• Psychiatric/Mental Health Nurse Practitioner in Brandon, MS
• Providers in Brandon, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.