Individual provider Active NPI

Kizzy Eymard Bailey, MD

  • Emergency Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1700046414
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21618 Issued in MS
Practice address
5001 Hardy St
Emergency Department
Hattiesburg, MS 39402-1308
Phone
(601) 268-8000
NPI assigned
Jun 16, 2008
Last updated
Jul 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21618 MS Primary

Addresses

Primary practice location

5001 Hardy St
Emergency Department
Hattiesburg, MS 39402-1308

Mailing address

5001 Hardy St
Emergency Department
Hattiesburg, MS 39402-1308
Phone (601) 268-8000

Other names 1

  • Kizzy Lynn Eymard Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110809000014 MS Practitioner - Emergency Medicine 6204976772 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21618MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Jan 24, 2018 Accepting new patients
Keystone Medical Services of Ms, Inc Emergency Medicine CurrentSince Aug 14, 2012 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
South Central Clinics, Inc CurrentSince Jan 24, 2018 Accepting new patients
App of Mississippi Ed, LLC Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
Memorial Hospital at Gulfport Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients

Locations

150 Reynoir St
Biloxi, MS 39530
Phone (228) 284-2389

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Interoperability endpoints

  • Direct secure messaging: kbailey@direct.mhg.com
  • Direct secure messaging: kizzy.bailey@direct.scrmc.com

Organizations & group practices 8

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1700046414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KIZZY",
        "middle_name": "EYMARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "21618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIZZY",
            "last_name": "EYMARD",
            "middle_name": "LYNN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.