Individual provider Active NPI

Kymberly A Holy, CRNA

  • Certified Registered Nurse Anesthetist
  • Flowood, MS
National Provider Identifier
1609819028
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R840912 Issued in MS
Practice address
2510 Lakeland Dr
Flowood, MS 39232-9513
Phone
(601) 355-1234
Fax
(601) 326-3566
NPI assigned
Jun 14, 2006
Last updated
Apr 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R840912 MS Primary

Addresses

Primary practice location

2510 Lakeland Dr
Flowood, MS 39232-9513

Mailing address

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (601) 355-1234

Other identifiers 1

IdentifierTypeStateIssuer
00121220MedicaidMS

Other names 1

  • Kymberly A Schmidt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000315 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264516061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Alliance Anesthesia of Mississippi PLLCGroup PAC ID 3173963949, 28 clinicians

Practice addresses (Care Compare)

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (604) 355-1234

Merit-based Incentive Payment System (MIPS)

Final score
76.9 of 100Reported as group
Quality
47.44
Promoting interoperability
98
Improvement activities
40
Cost
77.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R840912MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates, P.a. CurrentSince May 15, 2017 Accepting new patients
Gastrointestinal Associates, PA Nurse Anesthetist, Certified Registered CurrentSince May 15, 2017 Accepting new patients
Gi Alliance Anesthesia of Mississippi PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 4, 2014 Accepting new patients
Physicians Anesthesia Group, P.a. Past Accepting new patients

Locations

2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234

1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234

106 Highland Way
Ste 101
Madison, MS 39110
Phone (601) 355-1234

1926 23rd Ave
Meridian, MS 39301
Phone (601) 485-1131

Organizations & group practices 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1609819028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "601-355-1234",
            "fax_number": "601-326-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "601-355-1234",
            "fax_number": "601-326-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLY",
        "first_name": "KYMBERLY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R840912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121220",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYMBERLY",
            "last_name": "SCHMIDT",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.