KIMBERLY JO REDDEN (NPI# 1811404775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811404775 |
| Entity Type | Individual |
| Full Name | KIMBERLY JO REDDEN |
| Credential | AGNP |
| Practice Address |
100 Baptist Memorial Cir Ste 202 Oxford MS 38655-4476 |
| Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
| Practice Telephone | 6626362451 |
| Practice Fax Number | 6626362290 |
| Mailing Telephone | 9012273255 |
| Mailing Fax Number | 9012278591 |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2018-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
23629 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
902335 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
23629 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
902335 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7684 Airways Blvd, Southaven, MS 386715304 | 9014050275 | 9018692940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457709230 | Kimberly Rose Redden | Nurse Anesthetist, Certified Registered | 168 Kinsley St Ste 4, Nashua, NH 03060-3634 | 2016-06-02 |
| Street Address |
100 BAPTIST MEMORIAL CIR STE 202 |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-4476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609856269 | Robert Quinn Ingraham | Neurological Surgery | 100 Baptist Memorial Cir Ste 202, Oxford, MS 38655-4476 | 2006-01-19 |
| 1851889976 | Tammi Fulgham Lawrence | Physician Assistant | 100 Baptist Memorial Cir Ste 202, Oxford, MS 38655-4476 | 2018-04-24 |
| 1184080640 | Joshua Minga | Nurse Practitioner | 100 Baptist Memorial Cir Ste 202, Oxford, MS 38655-4476 | 2016-01-13 |
| 1568881530 | Devin Wells | Physical Medicine & Rehabilitation | 100 Baptist Memorial Cir Ste 202, Oxford, MS 38655 | 2014-04-07 |
| 1982968525 | Joshua D Hughes | Neurological Surgery | 100 Baptist Memorial Cir Ste 202, Oxford, MS 38655-4476 | 2012-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114399284 | Kristie G Jenkins | Nurse Practitioner | 2908 S Lamar Blvd, Suite 100, Oxford, MS 38655-5354 | 2015-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1316500887 | Hollie Waldron | Nurse Practitioner | 408 Council Cir Ste C, Tupelo, MS 38801-4949 | 2019-04-19 |
| 1063975621 | Sheila Ann Frederick | Nurse Practitioner | 65 Patton Cemetary Rd, Fulton, MS 38843-9353 | 2019-04-10 |
| 1992263685 | Nadine Theresa James | Nurse Practitioner | 1214 Velma St, Hattiesburg, MS 39402-2751 | 2019-03-12 |
| 1396202396 | Roxane Theresa Moncure | Nurse Practitioner | 919 Rutherford Dr, Jackson, MS 39206-2033 | 2019-02-26 |
| 1750889416 | Katherine Bolden | Nurse Practitioner | 1666 Highway 19 S, Meridian, MS 39301-8209 | 2018-01-29 |
| 1306350129 | Tamika M Broome | Nurse Practitioner | 350 W Woodrow Wilson Ave # 411, Jackson, MS 39213-7681 | 2017-12-01 |
| 1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
| 1134589930 | Rebecca L. Cauthen | Nurse Practitioner | 885 Liberty Rd Ste 300, Flowood, MS 39232-9006 | 2016-03-07 |
| 1699099911 | Michael Don King | Nurse Practitioner | 188 W Oxford St, Pontotoc, MS 38863-2006 | 2010-03-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.