Kenneth Hines MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

08354 Issued in MS

Legal business name

KENNETH HINES MD PA

Practice address

408 W Market St
Greenwood, MS 38930

Phone

(662) 455-1442

Fax

(662) 455-6065

NPI assigned

Oct 28, 2006

Organization subpart

No

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

Authorized official

Name

Kenneth Lee Hines, MD

Title

President 100 Percent Stockholder

Phone

(662) 455-1442

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1972689321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W MARKET ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-455-1442",
            "fax_number": "662-455-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W MARKET ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-455-1442",
            "fax_number": "662-455-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH HINES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-28",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT 100 PERCENT STOCKHOLDER",
        "authorized_official_telephone_number": "662-455-1442",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "08354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016211",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jalisha Shauntay Kee
• Kelly Health & Wellness Clinic LLC
• Karlee Kelly, FNP
• Shanekia Kemp, CMHT
• Vera Kemp
• David Erby Kent, LPC
• Kendall Kern
• Catherine Sterling Kidd, LICSW
• Davida Kilpatrick
• Regina Swims King, RN

• Internal Medicine Physician in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.