Individual provider Active NPI

Kimberly Kuykendall Marlar, FNP

  • Family Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1356667455
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R853437 Issued in MS
Practice address
611 Alcorn Dr Ste 230
Corinth, MS 38834-9323
Phone
(662) 287-5218
Fax
(662) 286-3186
NPI assigned
Apr 14, 2010
Last updated
Apr 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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 R853437 MS Primary

Addresses

Primary practice location

611 Alcorn Dr Ste 230
Corinth, MS 38834-9323

Mailing address

611 Alcorn Dr Ste 230
Corinth, MS 38834-9323
Phone (662) 287-5218

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
I20120424000135 MS Practitioner - Nurse Practitioner 8628230430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Cardiology AssociatesGroup PAC ID 8123295979, 3 clinicians

Practice addresses (Care Compare)

611 Alcorn Dr
Suite 230
Corinth, MS 38834-9323
Phone (662) 287-5218

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R853437MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince May 1, 2019 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince May 1, 2019 Accepting new patients
Magnolia Cardiology Associates CurrentSince Apr 2, 2012 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients

Locations

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

611 Alcorn Dr
Ste 230
Corinth, MS 38834
Phone (662) 287-5218

Interoperability endpoints

  • Direct secure messaging: kimberlymarlar@magnolia.medalliesdirect.net

Organizations & group practices 5

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.

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": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1356667455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR STE 230",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349323",
            "telephone_number": "662-287-5218",
            "fax_number": "662-286-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR STE 230",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349323",
            "telephone_number": "662-287-5218",
            "fax_number": "662-286-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLAR",
        "first_name": "KIMBERLY",
        "middle_name": "KUYKENDALL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R853437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.