Katherine Rose Wilson, CFNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R891627 Issued in MS

Practice address

117 Fairfield Dr
New Albany, MS 38652-3107

Phone

(662) 534-0029

NPI assigned

Aug 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katherine Blassingame Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.blassingame.1@31210.direct.athenahealth.com

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.

• New Albany OB/GYN Clinic PC

  • Clinic/Center
  • New Albany, MS
  • NPI 1851573737
  Medicare reassignment NPD

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1104292895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 ROAD 1275",
            "city": "BALDWYN",
            "state": "MS",
            "postal_code": "388246881",
            "telephone_number": "662-397-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FAIRFIELD DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523107",
            "telephone_number": "662-534-0029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Getwell Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388346762",
            "country_code": "US",
            "telephone_number": "662-331-8868",
            "fax_number": "662-534-0008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 Commonwealth Blvd",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388049301",
            "country_code": "US",
            "telephone_number": "662-346-8400",
            "fax_number": "662-534-0008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "621 Highway 7 S Ste G",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "MS",
            "postal_code": "386359108",
            "country_code": "US",
            "telephone_number": "662-333-1041",
            "fax_number": "662-534-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R891627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BLASSINGAME",
            "credential": "CFNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wild & Free Behavior, LLC
• Cameron Mitchell Wilkerson, FNP-C
• David Jo Williams, M.D.
• Magan Scott Williams, LCSW
• Vanessa Renee' Williams, CRNA
• Kimberly Pugh Winborn, DMD
• Winkler Vascular Consulting PLLC
• Wound Care Pro, LLC
• Xiaoxuan Yu

• Nurse Practitioner in New Albany, MS
• Providers in New Albany, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.