Kim Willams Truesdale, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R576972 Issued in MS

Practice address

139 North Oliver St
Brooksville, MS 39739

Phone

(662) 738-4424

Fax

(662) 738-4615

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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.

• RH Emergency Medicine of Och Regional LLC

  • Emergency Medicine Physician
  • Starkville, MS
  • NPI 1093532889

  MS

  Medicare reassignment Care Compare group NPD
• RH Mississippi Hospitalist Medicine, LLC

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1891541207

  MS

  Medicare reassignment NPD
• North Mississippi Medical Clinics Inc

  • Internal Medicine Physician
  • Tupelo, MS
  • NPI 1053469486

  MS

  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hosp Oktibbeha County Inc.

  • Rural Acute Care Hospital
  • Starkville, MS
  • NPI 1346112521

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RH Emergency Medicine of Och Regional LLC 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital-Oktibbeha County Hospital, Starkville, MS, CCN 250050

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 1, 2009.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1609949692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6637 GREENFIELD DR",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397736501",
            "telephone_number": "662-492-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 NORTH OLIVER ST",
            "city": "BROOKSVILLE",
            "state": "MS",
            "postal_code": "39739",
            "telephone_number": "662-738-4424",
            "fax_number": "662-738-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUESDALE",
        "first_name": "KIM",
        "middle_name": "WILLAMS",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R576972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113993",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Larry McCullouch Jr., MD
• Noxubee General Critical Access Hospital
• Noxubee General Critical Access Hospital
• Holly C Rigdon, NP
• Katelyn Ryan
• Williams Care Company
• Nakasha Shanise Williams

• All providers in Brooksville, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.

Verify at the official NPI Registry.