KIMYUANA JACKSON DORRIS PMHNP, AGNP-C - NPI 1184222374

Q: What is Kimyuana Jackson Dorris's NPI number?

The NPI number for Kimyuana Jackson Dorris is 1184222374. It was assigned to this individual provider in the NPPES registry on October 11, 2020.

Q: What is Kimyuana Jackson Dorris's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

On this page

About Kimyuana Jackson Dorris Pmhnp, Agnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMYUANA JACKSON DORRIS PMHNP, AGNP-C (NPI 1184222374) is an individual adult medicine provider in Flowood, Mississippi, licensed in Mississippi (904207) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1184222374

Entity TypeIndividualFemale

Primary Taxonomy207QA0505X

Provider Legal NameKIMYUANA JACKSON DORRISCredential: PMHNP, AGNP-C

Location Address215 KATHERINE DR STE AFlowood, MS 39232-9588

Mailing Address20 Hobo Fork RdNatchez, MS 39120-9025

Phone(601) 665-4162

Fax(888) 398-1151

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 11, 2020

Last NPPES UpdateFebruary 28, 20242 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2024

✔ NPI 1184222374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0505X

License✔ Licensed in MS · 904207

Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

215 KATHERINE DR STE A, Flowood, MS 39232

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1590 Springridge RdClinton, MS 39056-5606 · Phone (190) 456-3568

Location 220 Hobo Fork RdNatchez, MS 39120-9025 · Phone (601) 304-2558

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimyuana Jackson Dorris Pmhnp, Agnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547783318

PECOS Enrollment IDI20250402001695

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39232 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TATUM LEE SEVERINO I DNP, FNP-C

Nurse Practitioner (Primary Care)