Active NPI
Kimberly Course, BSW
- Case Manager/Care Coordinator
- Clinton, MS
National Provider Identifier
1568070589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 901 Highway 80 E
Clinton, MS 39056-5244 - Phone
- (601) 927-0188
- Fax
- (601) 292-7998
- NPI assigned
- Jul 15, 2020
- Last updated
- Jul 15, 2020
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
901 Highway 80 E
Clinton, MS 39056-5244
Mailing address
PO Box 2305
Clinton, MS 39060-2305
Phone (601) 927-0188
Other practice location 1
901 Highway 80 E
Clinton, MS 39056-5244
Phone (601) 927-0188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02551264 | Medicaid | MS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://urbanrehabinc.app.box.com/folder/0 | Health Information Exchange (HIE) |
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": "1594771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1568070589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2305",
"city": "CLINTON",
"state": "MS",
"postal_code": "390602305",
"telephone_number": "601-927-0188",
"fax_number": "601-292-7998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 HIGHWAY 80 E",
"city": "CLINTON",
"state": "MS",
"postal_code": "390565244",
"telephone_number": "601-927-0188",
"fax_number": "601-292-7998"
}
],
"practiceLocations": [
{
"address_1": "901 Highway 80 E",
"address_purpose": "LOCATION",
"city": "Clinton",
"state": "MS",
"postal_code": "390565244",
"country_code": "US",
"telephone_number": "601-927-0188",
"fax_number": "601-292-7998",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COURSE",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "BSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-15",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02551264",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://urbanrehabinc.app.box.com/folder/0",
"affiliation": "N",
"endpointDescription": "hippa compliant data server",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "PDF",
"address_1": "901 Highway 80 E",
"city": "Clinton",
"state": "MS",
"country_code": "US",
"postal_code": "390565244",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.