Individual provider Active NPI

Kimberly M Williams, CNM

  • Advanced Practice Midwife
  • Gulfport, MS
National Provider Identifier
1235107004
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R876822 Issued in MS
Practice address
4502 Old Pass Rd
Gulfport, MS 39501-2585
Phone
(228) 863-9977
Fax
(228) 863-9912
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R876822 MS Primary

Addresses

Primary practice location

4502 Old Pass Rd
Gulfport, MS 39501-2585

Mailing address

4502 Old Pass Rd
Gulfport, MS 39501-2585
Phone (228) 863-9977

Other identifiers 2

IdentifierTypeStateIssuer
07782252MedicaidMS
001174200MedicaidFL

Other names 1

  • Kimberly Mae Hill Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080207000179 MS Practitioner - Certified Nurse Midwife (CNM) 6305930116 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R876822MSMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Feb 23, 2021 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Ochsner Mississippi, LLC CurrentSince Feb 23, 2021 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

15190 Community Rd
Ste 330
Gulfport, MS 39503
Phone (228) 328-1401

4502 Old Pass Rd
Gulfport, MS 39501
Phone (228) 314-7226

Interoperability endpoints

  • Direct secure messaging: kwilliams1214163@direct.ochsner.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1235107004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 OLD PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012585",
            "telephone_number": "228-863-9977",
            "fax_number": "228-863-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 OLD PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012585",
            "telephone_number": "228-863-9977",
            "fax_number": "228-863-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MS",
            "license": "R876822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07782252",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001174200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HILL",
            "middle_name": "MAE",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.