Kimberly Gwen Mettetal, CFNP CPMHNP - Medicare Nurse Practitioner in Southaven, MS

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Kimberly Gwen Mettetal, CFNP CPMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Southaven, Mississippi. She graduated from nursing school in 1999 and has 26 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice The Gulf Coast Center and her current practice location is 8626 Airways Blvd, Southaven, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 772-5937.

Kimberly Gwen Mettetal is licensed to practice in Mississippi (license number R850409) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1194911453.

Contact Information

Kimberly Gwen Mettetal, CFNP CPMHNP
8626 Airways Blvd,
Southaven, MS 38671-2603
(662) 772-5937
(662) 772-5940

Map and Direction




Provider's Profile

Full NameKimberly Gwen Mettetal
GenderFemale
SpecialityNurse Practitioner
Experience26 Years
Location8626 Airways Blvd, Southaven, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kimberly Gwen Mettetal graduated from nursing school in 1999
  NPI Data:
  • NPI Number: 1194911453
  • Provider Enumeration Date: 09/20/2007
  • Last Update Date: 07/14/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 7315925708
  • Enrollment ID: I20180328002127

Medical Identifiers

Medical identifiers for Kimberly Gwen Mettetal such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194911453NPI-NPPES
06787540MedicaidMS
382605901MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family R850409 (Mississippi)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 2018026553 (Missouri)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health AP60842248 (Washington)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 8391-33 (Wisconsin)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 2018 (Oregon)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 5816 (Minnesota)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health AP136974 (Texas)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health R850409 (Mississippi)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
The Gulf Coast Center620482189518

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Gwen Mettetal allows following entities to bill medicare on her behalf.
Entity NameLubbock Regional Mhmr Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992708705
PECOS PAC ID: 6800782376
Enrollment ID: O20040223001289
Entity NameThe Gulf Coast Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245285899
PECOS PAC ID: 6204821895
Enrollment ID: O20040414001641
Entity NameTexana Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912954058
PECOS PAC ID: 7618963265
Enrollment ID: O20040421000535
Entity NameBurke Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396792420
PECOS PAC ID: 1254312077
Enrollment ID: O20040527000661
Entity NameTexas Panhandle Mental Health Mental Retardation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134188139
PECOS PAC ID: 0446200067
Enrollment ID: O20050131000802

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Gwen Mettetal is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kimberly Gwen Mettetal, CFNP CPMHNP
8626 Airways Blvd,
Southaven, MS 38671-2603

Ph: (662) 772-5937		Kimberly Gwen Mettetal, CFNP CPMHNP
8626 Airways Blvd,
Southaven, MS 38671-2603

Ph: (662) 772-5937

Reviews and Comments


Nurse Practitioner Nurses in Southaven, MS

Mr. Nathaniel Levi Bump, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 7111 Southcrest Pkwy Ste 109, Southaven, MS 38671
Phone: 662-503-7416    Fax: 662-349-9082
Ms. Sherlean D Shugars, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 2149 Stateline Rd W, Southaven, MS 38671
Phone: 662-342-1112    
Penny Marie Holley, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 3964 Goodman Rd E Ste 128-129, Southaven, MS 38672
Phone: 662-655-0456    Fax: 662-655-0457
Christopher Gully, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 363 Southcrest Cir Ste 202, Southaven, MS 38671
Phone: 901-226-0456    Fax: 901-226-0458
Mrs. Christy Le Anne Egbert, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 122 Airways Pl, Southaven, MS 38671
Phone: 662-349-9990    Fax: 662-349-2620
Misty Burton, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 391 Southcrest Cir, Southaven, MS 38671
Phone: 662-349-2659    
Rebecca Holly T Robertson, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 122 Airways Pl, Southaven, MS 38671
Phone: 662-349-9990    Fax: 662-349-2620

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.