Individual provider Active NPI

Kayla Lillian McCrory, PA-C

  • Medical Physician Assistant
  • Corinth, MS
National Provider Identifier
1063276277
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00773 Issued in MS
Practice address
100 Norman Rd
Corinth, MS 38834-9372
Phone
(662) 205-4762
NPI assigned
Feb 8, 2024
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00773 MS Primary

Addresses

Primary practice location

100 Norman Rd
Corinth, MS 38834-9372

Mailing address

100 Norman Rd
Corinth, MS 38834-9372
Phone (662) 205-4762

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240401000834 MS Practitioner - Physician Assistant 5496191413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mississippi Medical College, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Center of North Ms PAGroup PAC ID 7416006986, 7 clinicians

Practice addresses (Care Compare)

340 Court St
Tupelo, MS 38804-3910
Phone 66284462721005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00773MSMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: kmccrory@dermcenter1.emadirect.md

Organizations & group practices 1

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

Hospital & facility affiliations 1

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": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1063276277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORMAN RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349372",
            "telephone_number": "662-205-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORMAN RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349372",
            "telephone_number": "662-205-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRORY",
        "first_name": "KAYLA",
        "middle_name": "LILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MS",
            "license": "PA00773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.