Individual provider Active NPI

Kasie Holmes, FNP-C

  • Family Nurse Practitioner
  • Brookhaven, MS
National Provider Identifier
1265830541
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R885256 Issued in MS
Practice address
327 N Jackson St
Brookhaven, MS 39601-3041
Phone
(601) 833-3800
NPI assigned
Dec 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R885256 MS Primary

Addresses

Primary practice location

327 N Jackson St
Brookhaven, MS 39601-3041

Mailing address

327 N Jackson St
Brookhaven, MS 39601-3041
Phone (601) 833-3800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702000751 MS Practitioner - Nurse Practitioner 7012229131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier NP IncGroup PAC ID 9638421910, 6 clinicians
McComb Og-GYN AssociatedGroup PAC ID 6103833959, 4 clinicians

Practice addresses (Care Compare)

1714 White St
McComb, MS 39648-2712
Phone (601) 250-0066

205 Marion Ave
McComb, MS 39648-2705
Phone (601) 684-9116

415 Marion Ave
McComb, MS 39648-2709
Phone (205) 473-6261

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R885256MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McComb Og-GYN Associated CurrentSince Jan 1, 2018 Accepting new patients
H3 Healthcare, LLC Current Accepting new patients
Premier NP Inc Family CurrentSince Dec 1, 2018 Accepting new patients
Lumley Health Services LLC PastSince Apr 9, 2024 Accepting new patients

Locations

415 Marion Ave
McComb, MS 39648
Phone (601) 584-8700

501 S Locust St
McComb, MS 39648
Phone (601) 684-8111

205 Marion Ave
McComb, MS 39648
Phone (601) 250-4275

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1265830541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N JACKSON ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013041",
            "telephone_number": "601-833-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 N JACKSON ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013041",
            "telephone_number": "601-833-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "KASIE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R885256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

Verify at the official NPI Registry.