Individual provider Active NPI

Kimberly Michele Myer, FNP

  • Nurse Practitioner
  • Kosciusko, MS
National Provider Identifier
1427656230
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904201 Issued in MS
Practice address
220 Highway 12 W
Kosciusko, MS 39090-3208
Phone
(662) 290-3150
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904201 MS Primary
Nurse Practitioner 363L00000X 864405 MS

Addresses

Primary practice location

220 Highway 12 W
Kosciusko, MS 39090-3208

Mailing address

PO Box 11407 Dept 2639
Birmingham, AL 35246-2639
Phone (601) 292-4562

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
I20230622003250 MS Practitioner - Nurse Practitioner 8123486172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMC - Attala, LLCGroup PAC ID 6204142771, 3 clinicians

Practice addresses (Care Compare)

220 Hwy 12 W
Kosciusko, MS 39090-3208
Phone (662) 289-4311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
864405MSMDNurse Practitioner
904201MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urogynecology Associates, LLC CurrentSince Jun 1, 2023 Accepting new patients
BMC - Attala, LLC Family Medicine CurrentSince Sep 3, 2024 Accepting new patients

Locations

120 Stone Creek Blvd
Ste 200
Flowood, MS 39232
Phone (601) 822-2294

220 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-4311

Interoperability endpoints

  • Direct secure messaging: kimberly.myer.p1@direct.urogyn.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kmyer148704@direct.bmhcc.org
  • Direct secure messaging: kimberly.myer.p2@direct.urogyn.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1427656230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT 2639",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462639",
            "telephone_number": "601-292-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903208",
            "telephone_number": "662-290-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYER",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904201",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "864405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

Verify at the official NPI Registry.