Active NPI
Kimberly Michelle Dye
- Home Health Agency
- Clarksdale, MS
National Provider Identifier
1700304151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 1015 Sasse St
Clarksdale, MS 38614-7533 - Phone
- (662) 645-9050
- NPI assigned
- Sep 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1015 Sasse St
Clarksdale, MS 38614-7533
Mailing address
110 Yazoo Ave Ste 220
Clarksdale, MS 38614-4329
Other practice location 1
110 Yazoo Suite 220
Clarksdale, MS 38614
Phone (662) 645-9050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82-1109893 | Medicaid | MS | |
| 777666888 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1700304151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 YAZOO AVE STE 220",
"city": "CLARKSDALE",
"state": "MS",
"postal_code": "386144329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 SASSE ST",
"city": "CLARKSDALE",
"state": "MS",
"postal_code": "386147533",
"telephone_number": "662-645-9050"
}
],
"practiceLocations": [
{
"address_1": "110 Yazoo Suite 220",
"address_purpose": "LOCATION",
"city": "Clarksdale",
"state": "MS",
"postal_code": "38614",
"country_code": "US",
"telephone_number": "662-645-9050",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DYE",
"first_name": "KIMBERLY",
"middle_name": "MICHELLE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-06",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "82-1109893",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "777666888",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksdale, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.