KIMBERLY GWEN METTETAL C.F.N.P. CPMHNP
NPI 1194911453
Nurse Practitioner - Psychiatric/Mental Health in Southaven, MS

Active since September 20, 2007PECOS EnrolledAccepts Medicare Assignment
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671(662) 772-5937(662) 772-5940 Get Directions Write a Review

NPPES record last updated: July 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 8, 2019, Mar 8, 2019, Oct 3, 2018 and 2 more (5 updates tracked since 2018).

About Kimberly Gwen Mettetal C.f.n.p. Cpmhnp NPPES

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

KIMBERLY GWEN METTETAL C.F.N.P. CPMHNP (NPI 1194911453) is an individual psychiatric/mental health provider in Southaven, Mississippi, licensed in Mississippi (R850409) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS, maintains 8 additional practice locations, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1194911453
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKIMBERLY GWEN METTETALCredential: C.F.N.P. CPMHNP
Location Address8626 AIRWAYS BLVDSouthaven, MS 38671-2603
Mailing Address8626 Airways BlvdSouthaven, MS 38671-2603 · (662) 772-5937 · Fax (662) 772-5940
Fax(662) 772-5940
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateSeptember 20, 2007
Last NPPES UpdateJuly 14, 20255 updates tracked since enumeration
NPPES CertifiedJuly 14, 2025
NPI 1194911453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses Licensed in MS · R850409 Licensed in MO · 2018026553 Licensed in WA · AP60842248 Licensed in WI · 8391-33 Licensed in OR · 2018 Licensed in MN · 5816 Licensed in TX · AP136974
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License R850409 (MS)
8626 AIRWAYS BLVD, Southaven, MS 38671

Other Names 1

Other Name (5)Kimberly G Mettetal Pmhnp-bc

Secondary Practice Locations 8

Location 12001 S Medford DrLufkin, TX 75901-6260 · Phone (936) 639-1141 · Fax (936) 634-8601
Location 24050 Coon Rapids Blvd NWCoon Rapids, MN 55433-2522 · Phone (763) 236-6000
Location 31629 E Division StRiver Falls, WI 54022-1571 · Phone (715) 307-6000
Location 4311 E Main StSenatobia, MS 38668-2215 · Phone (662) 772-5937 · Fax (662) 772-5940
Location 51015 NW 22nd AvePortland, OR 97210-3025 · Phone (503) 413-7711
Location 62211 NE 139th StVancouver, WA 98686-2742 · Phone (360) 487-1000
Location 72505 Mission DrJefferson City, MO 65109-9508 · Phone (573) 681-3000
Location 8700 S Park StMadison, WI 53715-1830 · Phone (608) 251-6100

Other Identifiers 2

Medicaid06787540MS
Medicaid382605901TX

Accepted Insurance

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

Kimberly Gwen Mettetal C.f.n.p. Cpmhnp 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 ID7315925708
PECOS Enrollment IDI20180328002127
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
135 services59 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
31 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38671 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 20

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

Counselor (Professional)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Social Worker (Clinical)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Speech-Language Pathologist
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Counselor (Professional)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Counselor (Professional)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Social Worker (Clinical)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Counselor (Professional)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671
Counselor (Professional)
8626 AIRWAYS BLVD
SOUTHAVEN, MS 38671

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 Kimberly Mettetal's NPI number?

The NPI number for Kimberly Mettetal is 1194911453. It was assigned to this individual provider in the NPPES registry on September 20, 2007. The provider is also known as Kimberly G Mettetal Pmhnp-Bc.

Where is Kimberly Mettetal located?

Kimberly Mettetal practices at 8626 Airways Blvd, Southaven, MS 38671. The listed phone number is (662) 772-5937.

What is Kimberly Mettetal's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kimberly Mettetal enrolled in Medicare?

Yes. Kimberly Mettetal 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.

What insurance does Kimberly Mettetal accept?

Health plans from Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Texas, Community Health Choice and Molina Healthcare list Kimberly Mettetal 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 Kimberly Mettetal was last updated on July 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.