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Individual provider Active NPI

Kimberly Hannah McMillin, FNP

  • Family Nurse Practitioner
  • Starkville, MS
National Provider Identifier
1275147175
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904113 Issued in MS
Practice address
521 S Montgomery St Ste 3
Starkville, MS 39759-3337
Phone
(662) 767-4200
Fax
(662) 767-4204
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 904113 MS Primary

Addresses

Primary practice location

521 S Montgomery St Ste 3
Starkville, MS 39759-3337

Mailing address

1211 S Gloster St Ste a
Tupelo, MS 38801-6548
Phone (662) 767-4200

Other practice location 1

1211 S Gloster St
Tupelo, MS 38801-6546
Phone (662) 767-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126003333 MS Practitioner - Nurse Practitioner 3476967894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Orthopedic Group of Mississippi PLLCGroup PAC ID 3577878883, 41 clinicians

Practice addresses (Care Compare)

521 S Montgomery St
Suite 3
Starkville, MS 39759-3337
Phone (662) 767-4200

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Columbus, MS, CCN 257110
  • Baptist Memorial Hospital-Oktibbeha County Hospital, Starkville, MS, CCN 250050
  • BMH-Golden Triangle Hospital, Columbus, MS, CCN 250100
  • Noxubee General Critical Access Hosp Hospital, Macon, MS, CCN 251307
  • Clay County Medical Corporation Hospital, West Point, MS, CCN 250067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904113MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Orthopedic Group of Mississippi PLLC Current Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC CurrentSince Jan 1, 2021 Accepting new patients
Specialty Orthopedic Group of Ms, PLLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

303 Medical Center Dr
Batesville, MS 38606
Phone (662) 563-0155

521 S Montgomery St
Starkville, MS 39759
Phone (662) 338-4826

118 Highway 12 W
Starkville, MS 39759
Phone (662) 324-8070

521 S Montgomery St
#3
Starkville, MS 39759
Phone (662) 546-4400

1211 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-3380

Organizations & group practices 8

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 5

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1275147175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-767-4200",
            "fax_number": "662-767-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S MONTGOMERY ST STE 3",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593337",
            "telephone_number": "662-767-4200",
            "fax_number": "662-767-4204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 S Gloster St",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388016546",
            "country_code": "US",
            "telephone_number": "662-767-4200",
            "fax_number": "662-767-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLIN",
        "first_name": "KIMBERLY",
        "middle_name": "HANNAH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

Verify at the official NPI Registry.