Kimberly Tanner Fava, WHCNP, APRN in Clarksdale, MS

Kimberly Tanner Fava, WHCNP, APRN is a medicare enrolled "Nurse Practitioner" in Clarksdale, Mississippi. She graduated from nursing school in 2008 and has 16 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Womans Clinic, A Professional Association and her current practice location is 2000 N State St, Clarksdale, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 627-7361.

Kimberly Tanner Fava is licensed to practice in Mississippi (license number R854373) 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 1215195631.

Contact Information

	Kimberly Tanner Fava, WHCNP, APRN
	2000 N State St, Clarksdale, MS 38614-6100
	(662) 627-7361
	(662) 627-1158

Map and Direction

Provider's Profile

Full Name	Kimberly Tanner Fava
Gender	Female
Speciality	Nurse Practitioner
Experience	16 Years
Location	2000 N State St, Clarksdale, Mississippi
Accepts Medicare Assignments	Yes. 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 Tanner Fava graduated from nursing school in 2008

NPI Data:

NPI Number: 1215195631
Provider Enumeration Date: 06/02/2008
Last Update Date: 01/11/2023

Medicare PECOS Information:

PECOS PAC ID: 0547333973
Enrollment ID: I20080718000185

Medical Identifiers

Medical identifiers for Kimberly Tanner Fava such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215195631	NPI	-	NPPES
3459830	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LX0001X	Nurse Practitioner - Obstetrics & Gynecology	R854373 (Mississippi)	Secondary
363L00000X	Nurse Practitioner	R854373 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Northwest Mississippi Medical Center	Clarksdale, MS	Hospital
Methodist Healthcare - Olive Branch Hospital	Olive branch, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Womans Clinic, A Professional Association	1254228067	5

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 Tanner Fava allows following entities to bill medicare on her behalf.

Entity Name	Womans Clinic, A Professional Association
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043203136 PECOS PAC ID: 1254228067 Enrollment ID: O20050111000296

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 Tanner Fava 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 Address	Practice Location Address
Kimberly Tanner Fava, WHCNP, APRN 2000 N State St, Clarksdale, MS 38614-6100 Ph: (662) 627-7361	Kimberly Tanner Fava, WHCNP, APRN 2000 N State St, Clarksdale, MS 38614-6100 Ph: (662) 627-7361

Reviews and Comments

Nurse Practitioner Nurses in Clarksdale, MS

Margaret Chandler Lewis, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2245 N State St, Clarksdale, MS 38614 Phone: 662-627-4131 Fax: 662-627-4131
Mrs. Regina Denise Groner, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 619 S State St, Clarksdale, MS 38614 Phone: 662-966-1012
Gwenevere Chew, CFNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 340 Desoto Avenue Ext, Clarksdale, MS 38614 Phone: 662-741-2151 Fax: 662-741-2700
Anna Jones, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 220 Sunflower Ave, Clarksdale, MS 38614 Phone: 662-351-2035 Fax: 662-351-2045
Lashonda Lashay Bradley, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1967 Hospital Dr, Clarksdale, MS 38614 Phone: 662-624-5481 Fax: 662-621-1499
Dr. Carleen Thompson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1402 Miller Dr, Clarksdale, MS 38614 Phone: 662-627-8694
Undra L Haggan, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1202 Desoto Ave, Clarksdale, MS 38614 Phone: 662-202-1297

Kimberly Tanner Fava, WHCNP, APRN - Medicare Nurse Practitioner in Clarksdale, MS