Individual provider Active NPI

Kayla Bree Hodge, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1710646054
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
905541 Issued in MS
Practice address
4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737
Phone
(901) 763-0200
Fax
(901) 751-4002
NPI assigned
Dec 14, 2021
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 905541 MS Primary
Acute Care Nurse Practitioner 363LA2100X 30554 TN

Addresses

Primary practice location

4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-1290

Other practice location 2

7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200

Other practice location 3

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220125000199 TN Practitioner - Nurse Practitioner 0749672798 Reassigns benefits to 3 organizations
I20221102001040 MS Practitioner - Nurse Practitioner 0749672798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians

Practice addresses (Care Compare)

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-1290

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30554TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Group LLC Acute Care CurrentSince May 30, 2026 Accepting new patients
Consolidated Medical Practices of Memphis,PLLC CurrentSince Jan 3, 2022 Accepting new patients
Methodist Inpatient Physicians LLC CurrentSince Nov 7, 2022 Accepting new patients
Methodist Healthcare - Olive Branch Hospital PastSince May 30, 2026 Accepting new patients

Locations

4240 Bethel Rd
Ste 201
Olive Branch, MS 38654

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHBDD
  • Direct secure messaging: khodge28939@mlh.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1710646054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 BETHEL RD STE 201",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "901-763-0200",
            "fax_number": "901-751-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4250 Bethel Rd",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386548737",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7460 Wolf River Blvd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381760",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7691 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383904",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGE",
        "first_name": "KAYLA",
        "middle_name": "BREE",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "905541",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "30554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.