KANIESHIA M MITCHELL NP
NPI 1629614003
Nurse Practitioner in Gulfport, MS

Q: What is Kanieshia Mitchell's NPI number?

The NPI number for Kanieshia Mitchell is 1629614003. It was assigned to this individual provider in the NPPES registry on November 21, 2019.

Q: What is Kanieshia Mitchell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since November 21, 2019PECOS EnrolledAccepts Medicare Assignment

4500 13TH ST, GULFPORT, MS 39501(228) 867-4000 Get Directions Write a Review

NPPES record last updated: April 6, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 6, 2020, Nov 21, 2019 (2 updates tracked since 2019).

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About Kanieshia M Mitchell Np NPPES

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

KANIESHIA M MITCHELL NP (NPI 1629614003) is an individual nurse practitioner in Gulfport, Mississippi, licensed in Mississippi (903399) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS, is affiliated with St Dominic-jackson Memorial Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1629614003

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKANIESHIA M MITCHELLCredential: NP

Location Address4500 13TH STGulfport, MS 39501-2569

Mailing Address4500 13th StGulfport, MS 39501-2569 · (228) 867-4000

Phone(228) 867-4000

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateNovember 21, 2019

Last NPPES UpdateApril 6, 20202 updates tracked since enumeration

NPPES CertifiedApril 6, 2020

✔ NPI 1629614003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MS · 903399

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4500 13TH ST, Gulfport, MS 39501

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, UnitedHealthcare.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

Kanieshia M Mitchell Np 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 ID7315376431

PECOS Enrollment IDI20200410000452

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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Dominic-Jackson Memorial Hospital

Acute Care Hospitals · Jackson, MS

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number250048

Location969 Lakeland DrJackson, MS 39216 · Hinds County

Emergency services Birthing friendly

Mississippi Baptist Medical Center

Acute Care Hospitals · Jackson, MS

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number250102

Location1225 N State StJackson, MS 39202 · Hinds County

Emergency services Birthing friendly

Merit Health River Oaks

Acute Care Hospitals · Flowood, MS

1/5 CMS rating

OwnershipProprietary

CMS Certification Number250138

Location1030 River Oaks DriveFlowood, MS 39232 · Rankin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39501 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.

HEATHER LYN JEFFREY

Nurse Practitioner