Individual provider Active NPI

Holley Trimble

  • Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1861102196
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905688 Issued in MS
Practice address
3704 Highway 72 W
Corinth, MS 38834-8556
Phone
(662) 286-1499
Fax
(662) 286-9041
NPI assigned
Nov 28, 2022
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905688 MS Primary

Addresses

Primary practice location

3704 Highway 72 W
Corinth, MS 38834-8556

Mailing address

3704 Highway 72 W
Corinth, MS 38834-8556
Phone (662) 286-1499

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230412002330 MS Practitioner - Nurse Practitioner 5092180653 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Feb 2, 2026 Accepting new patients
Magnolia Regional Health Center CurrentSince Feb 2, 2026 Accepting new patients
Magnolia Family Clinic CurrentSince Nov 1, 2023 Accepting new patients
Magnolia Regional Health Center CurrentSince Dec 29, 2022 Accepting new patients

Locations

3704 Highway 72 W
Corinth, MS 38834
Phone (662) 286-1499

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

703 Alcorn Dr
Ste 109
Corinth, MS 38834
Phone (662) 286-1499

Organizations & group practices 5

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": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1861102196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 HIGHWAY 72 W",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388348556",
            "telephone_number": "662-286-1499",
            "fax_number": "662-286-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 HIGHWAY 72 W",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388348556",
            "telephone_number": "662-286-1499",
            "fax_number": "662-286-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBLE",
        "first_name": "HOLLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.