Kimberly Sharelle Watkins, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

905254 Issued in MS

Practice address

309 Magnolia Dr
Raleigh, MS 39153-6011

Phone

(601) 782-4244

NPI assigned

Apr 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Sharelle Noblin Former name

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Medical Consultants LLCGroup PAC ID 9830496314, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
• Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern Medical Consultants LLC

  • Primary Care Nurse Practitioner
  • Ridgeland, MS
  • NPI 1215396577

  MS

  Medicare reassignment Care Compare group NPD
• H&B Mission LLC

  • General Practice Physician
  • Ridgeland, MS
  • NPI 1568238889

  MS

  Medicare reassignment NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Health Clinic/Center
  • Batesville, MS
  • NPI 1700349222

  MS

  Medicare reassignment NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Acute Care Hospital
  • Batesville, MS
  • NPI 1053873307
  NPD

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585

  Hospital

  Care Compare affiliation
• Sta-Home Health Agency of Carthage, Inc

  • Home Health Agency
  • Carthage, MS
  • NPI 1275674533
  Care Compare affiliation
• Sta-Home Health Agency of Jackson, Inc.

  • Home Health Agency
  • Clinton, MS
  • NPI 1356482749
  Care Compare affiliation

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1376284752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 GEORGE RD",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390749082",
            "telephone_number": "601-697-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MAGNOLIA DR",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "391536011",
            "telephone_number": "601-782-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "KIMBERLY",
        "middle_name": "SHARELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NOBLIN",
            "middle_name": "SHARELLE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Raleigh, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.