Tyler Holmes Memorial Hospital
Organization Active NPI Family Nurse Practitioner · Kilmichael, MS
NPI 1346084985 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1346084985
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- TYLER HOLMES MEMORIAL HOSPITAL
- Practice address
- 400 Lamar Ave
Kilmichael, MS 39747-9780 - Phone
- (662) 283-4114
- NPI assigned
- Jun 19, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- TYLER HOLMES MEMORIAL HOSPITAL
Authorized official
- Name
- Cori H Bailey
- Title
- Administrator
- Phone
- (662) 283-4114
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 6
Practitioners 14
-
Brittany Nicole Allbritton, RN, FNP
-
Gene David Cathey, M.D.
-
Rebecca J Franklin, FNP-C
-
Amy Marie Gammel, FNP
-
Amy Gray Hancock, CFNP
-
William B Harper, D. O.
-
Julia Johnson, NP
-
Elizabeth Brown Kelly, CFNP
-
Sabrina Brown Matthews, NP-C
-
Steven Keith Rushing, M.D.
-
Maggie Taylor, CFNP
-
Mary Vaughn, DNP, FNP-C, PMHNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000826 | MS | Part B Supplier - Clinic/Group Practice | 0345142618 |
Receives reassigned benefits from 14 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Winona, MS; North Carrollton, MS; Kilmichael, MS |
National Provider Directory
- Tax ID family
- Tyler Holmes Memorial Hospital
- Part of
- Tyler Holmes Memorial Hospital
Locations
416 Tyler Holmes Dr
Winona, MS 38967
Phone (662) 283-4114
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | |||
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
400 Lamar Ave
Kilmichael, MS 39747-9780
Mailing address
409 Tyler Holmes Dr
Winona, MS 38967-1521
Phone (662) 283-4114
Other names
- Tyler Holmes Kilmichael Clinic
Other providers in Kilmichael, MS
- Kilmichael Hospital
- Kilmichael Hospital
- Kilmichael Hospital
- Rachel Montgomery
- Lajoyce Stewart
- Webster Health Services, Inc.
All providers in Kilmichael, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.