Kim Michelle Jones, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

904293 Issued in MS

Practice address

103 S 19TH Ave
Hattiesburg, MS 39401-6171

Phone

(601) 544-4641

NPI assigned

Nov 6, 2019

Last updated

Sep 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kim Michelle Stubbs Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psych-Solutions

  • Psychiatric/Mental Health Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1790585933

  Single Specialty

  Medicare reassignment NPD
• TBD Acquisition II LLC

  dba Gulfport Behavioral Health System

  • Psychiatric Hospital
  • Gulfport, MS
  • NPI 1750891792

  Single Specialty

  Medicare reassignment NPD
• TBD Acquisition II, LLC

  dba Gulfport Behavioral Health System

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1003324419

  Single Specialty

  NPD

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1245874981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1932",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394281932",
            "telephone_number": "601-408-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S 19TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016171",
            "telephone_number": "601-544-4641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11150 Highway 49",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395034110",
            "country_code": "US",
            "telephone_number": "228-831-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "KIM",
        "middle_name": "MICHELLE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R883514",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904293",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": "R883514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "STUBBS",
            "middle_name": "MICHELLE",
            "credential": "PMNHP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hunter Jones, PCMHT
• Jamyra Jones
• Jessica C. Jones, APRN
• Joshua Stephen Jones, DNP, CRNA
• Keri Sharday Jones, MD
• Kourtnei Jones, DNP, APRN, PMHNP-BC
• Lorin Jones, PA
• Madison Jones
• Marcelle C Jones
• Melissa Jones, CMHT

• Psychiatric/Mental Health Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, 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 Sep 27, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.