Kimberly M Stanley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R858096 Issued in MS

Practice address

285 Ivie LN
Mantachie, MS 38855-9764

Phone

(662) 282-4197

Fax

(662) 282-5121

NPI assigned

Mar 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hometown Care of Mantachie, LLCGroup PAC ID 4789917808, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBGIBD

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.

• Hometown Care of Mantachie LLC

  • Family Nurse Practitioner
  • Mantachie, MS
  • NPI 1164987426
  Medicare reassignment Care Compare group NPD
• Community Family Healthcare, Inc

  • Family Nurse Practitioner
  • Mantachie, MS
  • NPI 1891907093
  Medicare reassignment NPD

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

• North Mississippi Medical Center, Inc.

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1770824955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 FERGUSON LAKE RD",
            "city": "MARIETTA",
            "state": "MS",
            "postal_code": "388566068",
            "telephone_number": "662-401-3066",
            "fax_number": "662-842-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 IVIE LN",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388559764",
            "telephone_number": "662-282-4197",
            "fax_number": "662-282-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R858096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05838803",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Katlyn Spradling
• Virginia M Sprayberry, SLP
• Leita N Stark, FNP-BC
• Michael Ann Tally
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• Wal-Mart Stores East LP
• Paige Westmoreland, PMHNP

• Family Nurse Practitioner in Mantachie, MS
• Providers in Mantachie, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.