Kishina Shontrell Sanders, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

901734 Issued in MS

Practice address

768 Avery Blvd N
Ridgeland, MS 39157-5219

Phone

(601) 487-6482

Fax

(601) 487-6528

NPI assigned

Sep 10, 2016

Last updated

Sep 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Mississippi Civic Improvement Association, IncGroup PAC ID 4183533235, shared by 26 NPIs, 48 clinicians

Quinn Healthcare,PLLCGroup PAC ID 6204802796, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Quinn Healthcare,PLLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1821103920
  Medicare reassignment Care Compare group NPD
• Central Mississippi Civic Improvement Association, Inc

  dba Jackson Hinds Comprehensiv Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442
  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc

  dba Jackson Hinds Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Utica, MS
  • NPI 1700813052
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  dba Jackson Hinds Comprehensive Health Center Unit 7

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  dba Jackson-Hinds Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1154424554
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1619424330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 WOODDELL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392124043",
            "telephone_number": "601-201-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 AVERY BLVD N",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575219",
            "telephone_number": "601-487-6482",
            "fax_number": "601-487-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KISHINA",
        "middle_name": "SHONTRELL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-10",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Sahler, LPC
• Taban Salem, PH.D.
• Carrington Albernise Sallie, NP
• Larry Keith Salter Jr., OT
• Angela Marie Sanders, LCSW, LICSW
• Michael L Sanders, MD
• Britney Sandifer, FNP-C
• Emily H Sandifer, OTR/L
• Sankoorikal Family Medicine PLLC
• Kathryn Michelle Sansing, PMHNP-BC

• Family Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.