Kimberly King, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902083 Issued in MS

Practice address

415 S 28TH Ave
Hattiesburg, MS 39401

Phone

(601) 579-5010

Fax

(601) 579-5240

NPI assigned

Jul 12, 2017

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

Other identifiers 1

Electronic endpoints 1

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

Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians

Healthcare Plus Limited Liability CompanyGroup PAC ID 5698038610, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Homecare of Richton Home health agency, Richton, MS, CCN 257120
• Adoration Home Health Home health agency, Collins, MS, CCN 257087
• Panola Medical Center Hospital, Batesville, MS, CCN 250781
• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
• Perry County General Hospital Hospital, Richton, MS, CCN 250783

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kking46995@directpatientrecord.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.

• Wound Management Specialists, LLC

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1972150084
  Medicare reassignment Care Compare group NPD
• Healthcare Plus Limited Liability Company

  • Specialist
  • Metairie, LA
  • NPI 1063927465

  MS

  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Winston Medical Clinic LLC

  • Rural Health Clinic/Center
  • Louisville, MS
  • NPI 1629417324
  NPD (past)

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

• Amedisys Mississippi, LLC

  • Home Health Agency
  • Collins, MS
  • NPI 1467400168
  Care Compare affiliation
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• Forrest County General Hospital

  • Rural Acute Care Hospital
  • Richton, MS
  • NPI 1932143989
  Care Compare affiliation
• Leaf River Home Health Care, LLC

  • Home Health Agency
  • Richton, MS
  • NPI 1770521072
  Care Compare affiliation
• Strategic Solutions-Panola Medical Center LLC

  • Rural Acute Care Hospital
  • Batesville, MS
  • NPI 1053873307
  Care Compare affiliation

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1215459136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-579-5010",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39401",
            "telephone_number": "601-579-5010",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Circle J Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394401981",
            "country_code": "US",
            "telephone_number": "601-425-0092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07121734",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kking46995@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Burnham Kimbrough
• Amanda Patterson Kindel, FNP
• Danviona King
• Ernest Wade King Jr.
• Joseph King
• Thomas E King III, MD
• Kevin Kinloch, MD
• Sandra Kinnan, N.P.
• John Martin Kinsey, FNP
• Lauren Kirchhefer

• Family Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, 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 24, 2020; 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.