Individual provider Active NPI

Kaye Killings, CFNP

  • Adult Health Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1881636306
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R501565 Issued in MS
Practice address
5160 Galaxie Dr
Jackson, MS 39206-4308
Phone
(601) 713-0890
Fax
(601) 366-3415
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R501565 MS Primary

Addresses

Primary practice location

5160 Galaxie Dr
Jackson, MS 39206-4308

Mailing address

5160 Galaxie Dr
Jackson, MS 39206-4308
Phone (601) 713-0890

Other identifiers 1

IdentifierTypeStateIssuer
00111588MedicaidMS

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
I20070731000336 MS Practitioner - Nurse Practitioner 9830290105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Jackson Medical Clinic PLLCGroup PAC ID 4082715354, 2 clinicians

Practice addresses (Care Compare)

5160 Galaxie Dr
Jackson, MS 39206-4308
Phone (601) 713-0890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R501565MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Jackson Medical Clinic PLLC CurrentSince Dec 25, 2010 Accepting new patients

Locations

5160 Galaxie Dr
Jackson, MS 39206
Phone (601) 713-0890

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kaye.killings.p1@direct.northjacksonmedical.nextgenshare.com

Organizations & group practices 1

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.

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1881636306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 GALAXIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064308",
            "telephone_number": "601-713-0890",
            "fax_number": "601-366-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5160 GALAXIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064308",
            "telephone_number": "601-713-0890",
            "fax_number": "601-366-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLINGS",
        "first_name": "KAYE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R501565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00111588",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.