Active NPI
Gloria Jean Killingsworth
- Home Health Aide
- Hazelhurst, MS
National Provider Identifier
1407516909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 1305053
- Practice address
- 221 Magnolia St.
Hazelhurst, MS 39083 - Phone
- (601) 291-0852
- NPI assigned
- Dec 23, 2021
- Last updated
- Dec 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 1305053 | NU | Primary |
Addresses
Primary practice location
221 Magnolia St.
Hazelhurst, MS 39083
Mailing address
221 Magnolia St.
Hazelhurst, MS 39083
Phone (601) 291-0852
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1407516909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 MAGNOLIA ST.",
"city": "HAZELHURST",
"state": "MS",
"postal_code": "39083",
"telephone_number": "601-291-0852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 MAGNOLIA ST.",
"city": "HAZELHURST",
"state": "MS",
"postal_code": "39083",
"telephone_number": "601-291-0852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLINGSWORTH",
"first_name": "GLORIA",
"middle_name": "JEAN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-23",
"last_updated": "2021-12-23",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "NU",
"license": "1305053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazelhurst, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.