NPIMap

Organization Active NPI

Kids Bright Clinic LLC

  • Nurse Practitioner
  • Sumrall, MS
National Provider Identifier
1780341396
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
KIDS BRIGHT CLINIC LLC
Practice address
4881 Highway 589
Sumrall, MS 39482
Phone
(601) 336-9099
NPI assigned
Nov 18, 2021
Last updated
Apr 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Authorized official

Name
Amanda Whiddon
Title
NP/Owner
Phone
(601) 330-9099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

4881 Highway 589
Sumrall, MS 39482

Mailing address

PO Box 566
Sumrall, MS 39482-0566
Phone (601) 336-9099

National Provider Directory

National Provider Directory

Locations

7116 U S Highway 98
Hattiesburg, MS 39402

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1780341396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394820566",
            "telephone_number": "601-336-9099",
            "fax_number": "601-336-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 HIGHWAY 589",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "39482",
            "telephone_number": "601-336-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS BRIGHT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "WHIDDON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "NP/OWNER",
        "authorized_official_telephone_number": "601-330-9099"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumrall, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.