Individual provider Active NPI

Kim T Le

  • Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1346994183
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905128 Issued in MS
Practice address
4500 13TH St
Gulfport, MS 39501-2569
Phone
(228) 867-4000
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905128 MS Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2569

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 575-1194

Other practice location 1

1240 Broad Ave Ste B
Gulfport, MS 39501-2416
Phone (601) 456-5100

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
I20220224001833 MS Practitioner - Nurse Practitioner 3173917770 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Homedica of Louisiana, LLCGroup PAC ID 4789825837, 19 clinicians
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians
Care Doc LLCGroup PAC ID 7719223957, 21 clinicians

Practice addresses (Care Compare)

1240 Broad Ave
Suite B
Gulfport, MS 39501-2416
Phone (844) 414-2072

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Gulfport, MS, CCN 257143
  • Adoration Home Health Home health agency, Biloxi, MS, CCN 257100
  • Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
  • St Luke Home Health Services Home health agency, McComb, MS, CCN 257124
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905128MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
GSW Medical, LLC CurrentSince Jan 9, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Feb 14, 2022 Accepting new patients
Homedica of Mississippi, LLC CurrentSince Nov 27, 2023 Accepting new patients
Care Doc LLC CurrentSince Feb 7, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Feb 14, 2022 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Caredoc LLC CurrentSince Feb 7, 2024 Accepting new patients
Homedica of Louisiana, LLC CurrentSince Nov 27, 2023 Accepting new patients
South Mississippi Nephrology, PLLC CurrentSince May 15, 2023 Accepting new patients
D'Iberville Home Program, LLC PastSince Dec 27, 2020 Accepting new patients

Locations

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

14215 Cook Rd
Biloxi, MS 39532
Phone (228) 872-0516

784 Vieux Marche Mall
Biloxi, MS 39530
Phone (228) 374-2575

5401 Gex Rd
Diamondhead, MS 39525
Phone (228) 436-1225

10374 Lamey Bridge Rd
Diberville, MS 39540
Phone (228) 392-1300

3301 25th Ave
Gulfport, MS 39501
Phone (228) 436-9819

4300B W Railroad St
Gulfport, MS 39501
Phone (228) 863-5705

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

1240 Broad Ave
Ste B
Gulfport, MS 39501
Phone (601) 456-5100

11150 Highway 49
Gulfport, MS 39503
Phone (228) 575-1000

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

2525 33rd St
Gulfport, MS 39501
Phone (228) 436-1225

11531 Old Highway 49
Gulfport, MS 39503
Phone (228) 392-7760

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Interoperability endpoints

  • Direct secure messaging: kle@direct.mhg.com

Organizations & group practices 11

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 65

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

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1346994183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-575-1194",
            "fax_number": "228-575-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012569",
            "telephone_number": "228-867-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Broad Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395012416",
            "country_code": "US",
            "telephone_number": "601-456-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "KIM",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.