NPIMap

Individual provider Active NPI

Kim M. Tumminello, APRN

  • Family Nurse Practitioner
  • Pascagoula, MS
National Provider Identifier
1649548892
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R858093 Issued in MS
Practice address
4253 Denny Avenue
Pascagoula, MS 39581
Phone
(228) 938-0109
Fax
(228) 938-0555
NPI assigned
Dec 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP06674 LA
Family Nurse Practitioner 363LF0000X AP06674 LA
Family Nurse Practitioner 363LF0000X R858093 MS Primary

Addresses

Primary practice location

4253 Denny Avenue
Pascagoula, MS 39581

Mailing address

4253 Denny Avenue
Pascagoula, MS 39581
Phone (228) 938-0109

Other identifiers 1

IdentifierTypeStateIssuer
03072365MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150408000780 MS Practitioner - Nurse Practitioner 2860642998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 818-0563

2819 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 762-3466

7001 Hwy 614
Coastal Ambulatory Services
Hurley, MS 39555-5340
Phone (228) 588-6622

Hospital & facility affiliations

  • Singing River Health System Hospital, Pascagoula, MS, CCN 250040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06674LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Jan 15, 2022 Accepting new patients
Singing River Gulfport CurrentSince Jan 15, 2022 Accepting new patients
Singing River Health System CurrentSince Mar 23, 2015 Accepting new patients

Locations

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

3099 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 872-2403

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

4253 Denny Ave
Pascagoula, MS 39581
Phone (228) 627-9838

2819 Denny Ave
Pascagoula, MS 39581
Phone (228) 762-3466

11700 Highway 57
Vancleave, MS 39565
Phone (228) 826-1482

Organizations & group practices 12

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 2

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": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1649548892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4253 DENNY AVENUE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "39581",
            "telephone_number": "228-938-0109",
            "fax_number": "228-938-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4253 DENNY AVENUE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "39581",
            "telephone_number": "228-938-0109",
            "fax_number": "228-938-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMMINELLO",
        "first_name": "KIM",
        "middle_name": "M.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06674",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06674",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R858093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03072365",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.