Active NPI
Kimberly Michele Myer, FNP
- Nurse Practitioner
- Kosciusko, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 904201
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 864405 | MS | MD | Nurse Practitioner |
| 904201 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urogynecology Associates, LLC | Current | Accepting new patients | |
| BMC - Attala, LLC | Family Medicine | Current | 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
- kimberly.myer.p1@direct.urogyn.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- kmyer148704@direct.bmhcc.org
- 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.
-
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- Flowood, MS
- NPI 1649981846
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Kosciusko, MS
- NPI 1730566027
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1710909585
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.