Individual provider Active NPI

Kimsey Elise Millen, PA-C

  • Physician Assistant
  • Tuscaloosa, AL
National Provider Identifier
1396568051
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Rice Mine Road Loop Ste 205
Tuscaloosa, AL 35406-2419
Phone
(205) 391-4440
Fax
(205) 391-4441
NPI assigned
Nov 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

100 Rice Mine Road Loop Ste 205
Tuscaloosa, AL 35406-2419

Mailing address

100 Rice Mine Road Loop Ste 205
Tuscaloosa, AL 35406-2419
Phone (205) 391-4440

Other names 1

  • Kimsey Elise Aguero Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241216003836 MS Practitioner - Physician Assistant 1254868144 Reassigns benefits to 1 organization
I20260515001089 AL Practitioner - Physician Assistant 1254868144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16611 Bridle Ridge LN
Olney, MD 20832-2707

801 7TH Ave N
Columbus, MS 39701-4005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Services LLC CurrentSince Dec 10, 2024 Accepting new patients
North Mississippi Medical Center Services LLC Past Accepting new patients

Locations

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

4250 S Eason Blvd
Tupelo, MS 38801
Phone (662) 377-5265

Interoperability endpoints

  • Direct secure messaging: kimseyaguero@nmhs.medalliesdirect.net

Organizations & group practices 4

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": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1396568051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RICE MINE ROAD LOOP STE 205",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062419",
            "telephone_number": "205-391-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RICE MINE ROAD LOOP STE 205",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062419",
            "telephone_number": "205-391-4440",
            "fax_number": "205-391-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLEN",
        "first_name": "KIMSEY",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMSEY",
            "last_name": "AGUERO",
            "middle_name": "ELISE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.