MRS. KIMBERLIE LA'TASHA MABRY FNP-C
NPI 1891422853
Family Medicine in Gautier, MS
About Mrs. Kimberlie La'tasha Mabry Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KIMBERLIE LA'TASHA MABRY FNP-C (NPI 1891422853) is an individual family medicine provider in Gautier, Mississippi, licensed in Mississippi (905478) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
Accepted 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
Mrs. Kimberlie La'tasha Mabry Fnp-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.
Medicare Billing Reassignments
3Medicare enrollment records show Kimberlie Mabry reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hoover, AL 35216
- Reassigned Medicare billing, Louisiana enrollment
- 163 clinicians in this Medicare group
Lake Charles, LA 70605
- Reassigned Medicare billing, Louisiana enrollment
- 314 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Louisiana enrollment
- 439 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.
Areas of Expertise CMS Part B claims
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39553 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 Kimberlie Mabry's NPI number?
The NPI number for Kimberlie Mabry is 1891422853. It was assigned to this individual provider in the NPPES registry on August 1, 2022.
Where is Kimberlie Mabry located?
Kimberlie Mabry practices at 1509 Willowbend Dr, Gautier, MS 39553. The listed phone number is (228) 627-1223.
What is Kimberlie Mabry's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kimberlie Mabry enrolled in Medicare?
Yes. Kimberlie Mabry 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 Kimberlie Mabry's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberlie Mabry reassigns Medicare benefits to 3 organizations: Upperline Healthcare, PC (Hoover, AL), Calcasieu Urgent Care LLC (Lake Charles, LA) and Signify Health, LLC (Dallas, TX). 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 Kimberlie Mabry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberlie Mabry accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan list Kimberlie Mabry 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 Kimberlie Mabry was last updated on July 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mrs. Kimberlie La'tasha Mabry, FNP-C · NPI 1891422853
Family Medicine physician in Gautier, Mississippi. Individual provider, active in the CMS NPPES registry since August 1, 2022.
## Identity
- **NPI:** 1891422853 (Entity type: Individual)
- **Enumerated:** August 1, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 905478 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1509 WILLOWBEND DR, Gautier, MS 39553-7627
- **Phone:** (228) 627-1223
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Upperline Healthcare, PC (NPI 1538686498, Hoover, AL); Calcasieu Urgent Care LLC (NPI 1467715490, Lake Charles, LA); Signify Health, LLC (NPI 1689158487, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** July 18, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1891422853) · Data from the CMS NPPES public registry.