NPIMap

Individual provider Active NPI

Kimberly Owen Loe, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1881928315
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R862120 Issued in MS
Practice address
4290 Lakeland Dr
Suite a
Flowood, MS 39232-9571
Phone
(601) 932-0083
Fax
(601) 932-8124
NPI assigned
Sep 30, 2009
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R862120 MS Primary

Addresses

Primary practice location

4290 Lakeland Dr
Suite a
Flowood, MS 39232-9571

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000154 MS Practitioner - Nurse Practitioner 3375685068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Urology Clinic PLLCGroup PAC ID 6406830942, 14 clinicians

Practice addresses (Care Compare)

501 Marshall St
Suite 301
Jackson, MS 39202-1687
Phone (601) 353-9900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R862120MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Urology Clinic, PLLC CurrentSince Jun 5, 2023 Accepting new patients
Mississippi Urology Clinic, PLLC PastSince Sep 24, 2023 Accepting new patients
Rankin Family Practice Inc Family PastSince Jan 1, 2012 Accepting new patients

Locations

1100 Highway 16 E
Carthage, MS 39051
Phone (601) 267-1100

1029 River Oaks Dr
Jackson, MS 39232
Phone (601) 664-1000

1040 River Oaks Dr
Ste 202
Jackson, MS 39232

501 Marshall St
Ste 301
Jackson, MS 39202

971 Lakeland Dr
Ste 657
Jackson, MS 39216
Phone (601) 200-2780

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc32520_mississippiurologyclinic
  • Direct secure messaging: kimberlyloe@muc.medalliesdirect.net

Organizations & group practices 3

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 7

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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1881928315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4880",
            "fax_number": "601-200-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 LAKELAND DR",
            "address_2": "SUITE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329571",
            "telephone_number": "601-932-0083",
            "fax_number": "601-932-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOE",
        "first_name": "KIMBERLY",
        "middle_name": "OWEN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R862120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.