Individual provider Active NPI

Kelly Lynn Tinson, NP-C

  • Family Nurse Practitioner
  • Biloxi, MS
National Provider Identifier
1407336423
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902568 Issued in MS
Practice address
1025 Division St Ste B
Biloxi, MS 39530-2910
Phone
(228) 388-2599
NPI assigned
Aug 20, 2018
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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 902568 MS Primary

Addresses

Primary practice location

1025 Division St Ste B
Biloxi, MS 39530-2910

Mailing address

2713 Barkwood LN
Vancleave, MS 39565-0400
Phone (228) 219-0498

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
I20181115002895 MS Practitioner - Nurse Practitioner 5294089900 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

180 Debuys Rd
Biloxi, MS 39531-4402
Phone (228) 865-1330

3265 Hwy 90
Gautier, MS 39553-5121
Phone (931) 253-1110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
902568MSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
TBD Acquisition II, LLC CurrentSince Sep 24, 2018 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince May 1, 2024 Accepting new patients
Region XII Commission CurrentSince Mar 9, 2022 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
TBD Acquisition II LLC Current Accepting new patients
TBD Acquisition II LLC CurrentSince Sep 24, 2018 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince May 1, 2024 Accepting new patients
Primesource Nursing Services, Inc CurrentSince Aug 15, 2022 Accepting new patients
Primesource Nursing Services, Inc Family Current Accepting new patients
Region 12 Commission on Mental Health & Retardation Pine Belt Men CurrentSince Mar 9, 2022 Accepting new patients

Locations

180 Debuys Rd
Biloxi, MS 39531
Phone (228) 338-0220

3265 Highway 90
Gautier, MS 39553
Phone (228) 366-9136

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

370 Courthouse Rd
Ste 106
Gulfport, MS 39507

103 S 19th Ave
Hattiesburg, MS 39401
Phone (601) 544-4222

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Organizations & group practices 12

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1407336423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 BARKWOOD LN",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395650400",
            "telephone_number": "228-219-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 DIVISION ST STE B",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395302910",
            "telephone_number": "228-388-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.