NPIMap

Individual provider Active NPI

Kimberly Gholar

  • Home Health Agency
  • Prentiss, MS
National Provider Identifier
1376714667
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
1814 Columbia Ave Ste B
Prentiss, MS 39474-0177
Phone
(601) 792-0664
Fax
(844) 274-1342
NPI assigned
Mar 14, 2008
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary
Phlebotomy Technician 246RP1900X NU
Health & Wellness Coach 171400000X NU

Addresses

Primary practice location

1814 Columbia Ave Ste B
Prentiss, MS 39474-0177

Mailing address

PO Box 177
Prentiss, MS 39474-0177
Phone (601) 441-3537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nfinity Private Duty Home Health LLC In Home Supportive Care Current Accepting new patients
Nfinity Innovative Solutions LLC Health & Wellness Coach Current Accepting new patients
Caring Hands Personal Care LLC Home Health Current Accepting new patients

Locations

1814 Columbia Ave
Ste B
Prentiss, MS 39474
Phone (601) 792-0664

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.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1376714667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 177",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394740177",
            "telephone_number": "601-441-3537",
            "fax_number": "601-792-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 COLUMBIA AVE STE B",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394740177",
            "telephone_number": "601-792-0664",
            "fax_number": "844-274-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOLAR",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prentiss, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.