Individual provider Active NPI

Kori Screws Bufkin

  • Family Nurse Practitioner
  • Vicksburg, MS
National Provider Identifier
1285511394
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907505 Issued in MS
Practice address
2080 S Frontage Rd
Vicksburg, MS 39180-5328
Phone
(601) 420-2040
NPI assigned
Aug 19, 2025
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 907505 MS Primary

Addresses

Primary practice location

2080 S Frontage Rd
Vicksburg, MS 39180-5328

Mailing address

106 Bobbie PL
Vicksburg, MS 39180-7032
Phone (601) 218-8414

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
I20260122001725 MS Practitioner - Nurse Practitioner 9537646435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flowood Pain Center, LLCGroup PAC ID 6901154293, 25 clinicians

Practice addresses (Care Compare)

2080 S Frontage Rd
Suite 112
Vicksburg, MS 39180-5882
Phone (601) 883-6304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
907505MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flowood Pain Center, LLC CurrentSince Dec 14, 2025 Accepting new patients

Locations

120 Stone Creek Blvd
Ste 500
Flowood, MS 39232
Phone (601) 202-2040

27190 Highway 28
Hazlehurst, MS 39083
Phone (601) 574-7000

970 Lakeland Dr
Ste 45
Jackson, MS 39216
Phone (601) 200-4690

2080 S Frontage Rd
Ste 112
Vicksburg, MS 39180
Phone (601) 883-6303

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEHEBD

Organizations & group practices 1

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": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1285511394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BOBBIE PL",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391807032",
            "telephone_number": "601-218-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805328",
            "telephone_number": "601-420-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFKIN",
        "first_name": "KORI",
        "middle_name": "SCREWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.