Kimberly Carson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902048 Issued in MS

Practice address

1832 Hospital Dr
Jackson, MS 39204-3410

Phone

(601) 371-8883

Fax

(844) 318-4882

NPI assigned

Jun 7, 2017

Sex

Female

Sole proprietor

Yes

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

Brentwood Acquisition IncGroup PAC ID 9133101074, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.carson.1@19302.direct.athenahealth.com

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.

• Brentwood Acquisition Inc

  • Psychiatric Hospital
  • Flowood, MS
  • NPI 1487638441
  Medicare reassignment Care Compare group NPD
• Gateway Wellness Clinic

  • Primary Care Clinic/Center
  • Vicksburg, MS
  • NPI 1881567568
  Medicare reassignment NPD Authorized official
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• Gateway Behavioral Health Services

  dba Gateway Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vicksburg, MS
  • NPI 1306362082
  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD

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

• Southwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • McComb, MS
  • NPI 1407805971
  Care Compare affiliation

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1174052773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 FUNCHES RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391808037",
            "telephone_number": "214-620-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 HOSPITAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043410",
            "telephone_number": "601-371-8883",
            "fax_number": "844-318-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "KIMBERLY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Carroll, M.D.
• Laura S Carroll, CFNP
• Paula Carroll, N.P.
• Jeffery D Carron, MD
• Christopher Carson, FNP-C, PMHNP-BC
• Valerie Carson, LMSW
• Amanda Carter, FNP-C
• April Carter, FNP-C
• Cassi Carter, RN, FNP-C
• Cassidy Carter, MD

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; 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.