Individual provider Active NPI

Kim Elliot Nagel, MD

  • Psychiatry Physician
  • Meridian, MS
National Provider Identifier
1235373663
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20088 Issued in MS
Practice address
4555 Highland Park Dr
Meridian, MS 39307-5429
Phone
(601) 581-7687
Fax
(601) 483-5543
NPI assigned
Apr 29, 2009
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20088 MS Primary

Addresses

Primary practice location

4555 Highland Park Dr
Meridian, MS 39307-5429

Mailing address

PO Box 4128
Meridian, MS 39304-4128
Phone (601) 581-7687

Other identifiers 1

IdentifierTypeStateIssuer
02855315MedicaidMS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000718 MS Practitioner - Psychiatry 2567357247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20088MSMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Mississippi State Hospital CurrentSince May 1, 2013 Accepting new patients
East Mississippi State Hospital Current Accepting new patients

Locations

4555 Highland Park Dr
Meridian, MS 39307
Phone (601) 482-6186

Organizations & group practices 2

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1235373663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4128",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393044128",
            "telephone_number": "601-581-7687",
            "fax_number": "601-483-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 HIGHLAND PARK DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075429",
            "telephone_number": "601-581-7687",
            "fax_number": "601-483-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGEL",
        "first_name": "KIM",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "20088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02855315",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.