Kimberly Sprouse, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

901790 Issued in MS

Practice address

3189 Highway 45 N
Suite H
Columbus, MS 39705-1251

Phone

(662) 570-4507

NPI assigned

Mar 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med 360 Urgent Care Northport LLCGroup PAC ID 5193180297, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim.sprouse.1@11777.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/16677/brand/1/csg/1/fhir/r4

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.

• Med 360 Urgent Care Northport LLC

  • Family Medicine Physician
  • Northport, AL
  • NPI 1073238747
  Medicare reassignment Care Compare group NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  MS

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL, MS

  Medicare reassignment NPD
• Weekends Plus Urgent Care LLC

  • Clinic/Center
  • Columbus, MS
  • NPI 1639625411
  NPD (past)
• Farouk a. Raquib, M.D., P.C.

  • Family Medicine Physician
  • Winfield, AL
  • NPI 1760531479
  NPD (past)

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1922549773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 TOWN BRANCH RD",
            "city": "VERNON",
            "state": "AL",
            "postal_code": "355925624",
            "telephone_number": "662-574-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3189 HIGHWAY 45 N",
            "address_2": "SUITE H",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051251",
            "telephone_number": "662-570-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROUSE",
        "first_name": "KIMBERLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Hearts Homecare Agency, LLC
• Southern Hospitality Transportation
• Southern Pharmaceutical Corporation
• Southern Sickroom Supply
• Sparrows United Transportation
• John Stanback, MD
• John W. Starr Jr., DMD
• Jerry L Stennett, M.D.
• Maria M Stephens, CFNP
• Steven M. Porter, DDS

• Family Nurse Practitioner in Columbus, MS
• Providers in Columbus, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.