Individual provider Active NPI

Mollie Jo Kinard, FNP-C

  • Family Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1619476652
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902505 Issued in MS
Practice address
9066 Highland St
Olive Branch, MS 38654-2307
Phone
(662) 890-7717
NPI assigned
Feb 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902505 MS Primary

Addresses

Primary practice location

9066 Highland St
Olive Branch, MS 38654-2307

Mailing address

959 Mount Peel Rd
Holly Springs, MS 38635-7597

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180702001640 MS Practitioner - Nurse Practitioner 5890041032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Old Towne Medical LLCGroup PAC ID 9032434881, 4 clinicians

Practice addresses (Care Compare)

9066 Highland St
Olive Branch, MS 38654-2307
Phone (662) 874-6164

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
902505MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Old Towne Medical LLC Family CurrentSince Apr 5, 2021 Accepting new patients
Marshall Urgent Care Family PastSince Dec 8, 2017 Accepting new patients

Locations

9066 Highland St
Olive Branch, MS 38654
Phone (662) 874-6164

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15038/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: mollie.kinard.1@15038.direct.athenahealth.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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1619476652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 MOUNT PEEL RD",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386357597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9066 HIGHLAND ST",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542307",
            "telephone_number": "662-890-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINARD",
        "first_name": "MOLLIE",
        "middle_name": "JO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.