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KIMYUANA JACKSON DORRIS PMHNP, AGNP-C
NPI 1184222374
Family Medicine - Adult Medicine in Flowood, MS

Active since October 11, 2020PECOS EnrolledAccepts Medicare Assignment
215 KATHERINE DR STE A, FLOWOOD, MS 39232(601) 665-4162(888) 398-1151 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 6, 2026, Dec 4, 2023, Oct 11, 2020 (3 updates tracked since 2020).

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 UpdateAugust 6, 20263 updates tracked since enumeration
NPPES CertifiedAugust 6, 2026
✔ 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 ↗

Other Names 1

Other Name (5)Kimyuana Dorris

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kimyuana Jackson Dorris reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Maxie Gordon MD & Associates, PLLC
14 mi
Psychiatry
590 SPRINGRIDGE RD
Clinton, MS 39056
  • Reassigned Medicare billing, Mississippi enrollment
  • 7 clinicians in this Medicare group
NPI 1114105665 (601) 488-8101
Np Care Anywhere LLC
14 mi
Adult Medicine
590 SPRINGRIDGE RD
Clinton, MS 39056
  • Reassigned Medicare billing, Mississippi enrollment
NPI 1609718915 (601) 488-8101

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 12

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)
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
ANUJ MARYA MD
Family Medicine
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
MARY T SMITH FNP
Nurse Practitioner (Family)
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
PAULA PERTEET FNP
Nurse Practitioner
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
MS. RAVA PITTMAN FNP-BC
Nurse Practitioner (Family)
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
CHRISTIAN DAVID MINOR
Nurse Practitioner (Psychiatric/Mental Health)
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
GLADYS SCOTT NP
Nurse Practitioner (Family)
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162
MS. LAURIE SHANNON STEWARD NP
Nurse Practitioner
215 KATHERINE DR STE A
FLOWOOD, MS 39232
Rankin County (601) 665-4162

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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. The provider is also known as Kimyuana Dorris.

Where is Kimyuana Jackson Dorris located?

Kimyuana Jackson Dorris practices at 215 Katherine Dr Ste A, Flowood, MS 39232. The listed phone number is (601) 665-4162.

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.

Is Kimyuana Jackson Dorris enrolled in Medicare?

Yes. Kimyuana Jackson Dorris is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kimyuana Jackson Dorris's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimyuana Jackson Dorris reassigns Medicare benefits to 2 organizations: Maxie Gordon MD & Associates, PLLC (Clinton, MS) and Np Care Anywhere LLC (Clinton, MS). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimyuana Jackson Dorris's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimyuana Jackson Dorris accept?

Health plans from Molina Healthcare and Oscar Health Plan, Inc. list Kimyuana Jackson Dorris as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimyuana Jackson Dorris was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.