SHIRLEY KIMBLE
NPI 1306673553
Nurse Practitioner - Primary Care in Doddsville, MS
About Shirley Kimble NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHIRLEY KIMBLE (NPI 1306673553) is an individual primary care provider in Doddsville, Mississippi, licensed in Mississippi (906327) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Greenville.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shirley Kimble is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shirley Kimble reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Dallas, TX 75244
- Reassigned Medicare billing, Mississippi enrollment
- 202 clinicians in this Medicare group
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 38736 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Shirley Kimble's NPI number?
The NPI number for Shirley Kimble is 1306673553. It was assigned to this individual provider in the NPPES registry on September 19, 2024.
Where is Shirley Kimble located?
Shirley Kimble practices at 106 Pond Street Ext, Doddsville, MS 38736. The listed phone number is (662) 402-6884.
What is Shirley Kimble's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Shirley Kimble enrolled in Medicare?
Yes. Shirley Kimble is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shirley Kimble's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shirley Kimble reassigns Medicare benefits to Signify Health, LLC (Dallas, TX). The 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 Shirley Kimble's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shirley Kimble was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Shirley Kimble · NPI 1306673553
Primary Care physician in Doddsville, Mississippi. Individual provider, active in the CMS NPPES registry since September 19, 2024.
## Identity
- **NPI:** 1306673553 (Entity type: Individual)
- **Enumerated:** September 19, 2024
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 906327 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 106 POND STREET EXT, Doddsville, MS 38736
- **Phone:** (662) 402-6884
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Signify Health, LLC (NPI 1689158487, Dallas, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 19, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1306673553) · Data from the CMS NPPES public registry.