Individual provider Active NPI

Kulmoris Joiner

  • Home Health Aide
  • Jackson, MS
National Provider Identifier
1891189767
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
06023302 Issued in MS
Practice address
350 West Woodrow Wilson Avenue
Suite 145
Jackson, MS 39213
Phone
(601) 807-5496
Fax
(769) 233-8840
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X 05671361 MS
Home Health Aide 374U00000X 06023302 MS Primary

Addresses

Primary practice location

350 West Woodrow Wilson Avenue
Suite 145
Jackson, MS 39213

Mailing address

350 W Woodrow Wilson Ave
Suite 145
Jackson, MS 39213-7681
Phone (601) 807-5496

Other identifiers 2

IdentifierTypeStateIssuer
05671361MedicaidMS
06023302MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
06023302MSMDHome Health Aide
05671361MSMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1891189767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "address_2": "SUITE 145",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-807-5496",
            "fax_number": "769-233-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 WEST WOODROW WILSON AVENUE",
            "address_2": "SUITE 145",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-807-5496",
            "fax_number": "769-233-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOINER",
        "first_name": "KULMORIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "MS",
            "license": "05671361",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MS",
            "license": "06023302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05671361",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06023302",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.