Individual provider Active NPI

Katherine O'Neal Royals, M.D.

  • Family Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1013357334
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24377 Issued in MS
Practice address
15 Orleans Dr
Hattiesburg, MS 39402-8675
Phone
(601) 579-5050
Fax
(601) 579-5240
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24377 MS Primary

Addresses

Primary practice location

15 Orleans Dr
Hattiesburg, MS 39402-8675

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 794-8065

Other identifiers 1

IdentifierTypeStateIssuer
03957766MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kroyals53822@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160917000081 MS Practitioner - Family Practice 0547584211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

102 Shelby Speights Dr
Purvis, MS 39475-4151
Phone (601) 794-8065

15 Orleans Dr
Hattiesburg, MS 39402-8675
Phone (601) 579-5050

415 S 28TH Ave
Hattiesburg, MS 39401-7246

415 S 28TH Ave 3Rd Floor
Ambulatory Cardiovascular Center of Mississ
Hattiesburg, MS 39401-7246
Phone (601) 268-1734

415 S 28TH Ave FL
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

4209 Lincoln Rd
Hattiesburg, MS 39402-3065
Phone (601) 264-6000

5192 Old Hwy 11
Suite 2
Hattiesburg, MS 39402-6222
Phone (601) 264-6000

Hospital & facility affiliations

  • Forrest General Home Care Home health agency, Hattiesburg, MS, CCN 257127
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
  • Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24377MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Aug 22, 2016 Accepting new patients
Hattiesburg Clinic PA CurrentSince Aug 22, 2016 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

15 Orleans Dr
Hattiesburg, MS 39402
Phone (601) 450-1370

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

202 W Main Ave
Lumberton, MS 39455
Phone (601) 528-9749

102 Shelby Speights Dr
Purvis, MS 39475
Phone (601) 794-8065

Interoperability endpoints

  • Direct secure messaging: kroyals53822@directpatientrecord.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1013357334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-794-8065",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ORLEANS DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028675",
            "telephone_number": "601-579-5050",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYALS",
        "first_name": "KATHERINE",
        "middle_name": "O'NEAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03957766",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroyals53822@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "102 Shelby Speights Dr",
            "city": "Purvis",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394754151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.