Individual provider Active NPI

Kristy Disabatino McRaney, PH.D.

  • Psychologist
  • Hattiesburg, MS
National Provider Identifier
1003364472
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
129 Golden Eagle Avenue RM 201
Hattiesburg, MS 39406-0001
Phone
(601) 266-4588
Fax
(601) 266-6928
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

129 Golden Eagle Avenue RM 201
Hattiesburg, MS 39406-0001

Mailing address

118 College Dr # 5194
Hattiesburg, MS 39406-0001
Phone (601) 266-4588

Other practice location 1

32 Millbranch Rd Ste 40
Hattiesburg, MS 39402-1673
Phone (601) 255-5264

Other practice location 2

12837 Flushing Meadows Dr
Suite 220
Saint Louis, MO 63131-1824
Phone (314) 516-7460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University of Southern Mississippi Psychologist CurrentSince Jul 17, 2022 Accepting new patients
Curators of the University of Missouri Past Accepting new patients

Locations

129 Golden Eagle Ave
Rm 201
Hattiesburg, MS 39406
Phone (601) 266-4588

118 College Dr
#5194
Hattiesburg, MS 39406

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1003364472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 COLLEGE DR # 5194",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394060001",
            "telephone_number": "601-266-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 GOLDEN EAGLE AVENUE RM 201",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394060001",
            "telephone_number": "601-266-4588",
            "fax_number": "601-266-6928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32 Millbranch Rd Ste 40",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021673",
            "country_code": "US",
            "telephone_number": "601-255-5264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12837 Flushing Meadows Dr",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631311824",
            "country_code": "US",
            "telephone_number": "314-516-7460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCRANEY",
        "first_name": "KRISTY",
        "middle_name": "DISABATINO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.