Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mimi Ann Kingery, PA

Individual provider Medical Physician Assistant · NPI 1790065035

Mimi Ann Kingery, PA is a Physician Assistant in Pensacola, Florida. Graduated from University of South Alabama College of Medicine in 2011, 15 years ago. Practices with Southeast Missouri Hospital Physicians LLC, a 206-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
15
Trained at
University of South Alabama College of Medicine
Licensed in
FL
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5147 N 9th Ave Ste 311
Pensacola, FL 32504-8770
Phone: (850) 477-2597
Fax: (850) 478-7941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9106214 (FL)

Record details

NPI number1790065035
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedAugust 18, 2011
Last updated in NPPESApril 11, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Southeast Missouri Hospital Physicians Llc — 206 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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