Katherine Puckett Ginn, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

902808 Issued in MS

Practice address

969 Lakeland Dr
Jackson, MS 39216-4606

Phone

(601) 200-2637

NPI assigned

Jul 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Dominic Medical Associates LLCGroup PAC ID 0446303168, 130 clinicians

St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kginn5370314@direct.casso.us.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.323

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.

• St. Dominic Jackson Memorial

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235173691
  Medicare reassignment Care Compare group NPD
• St. Dominic Medical Associates LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1407920549
  Medicare reassignment Care Compare group NPD
• Jackson Pulmonary Associates, PA

  • Pulmonary Disease Physician
  • Jackson, MS
  • NPI 1174570584
  Medicare reassignment NPD
• St Dominic Hospital Crna'S

  • Certified Registered Nurse Anesthetist
  • Jackson, MS
  • NPI 1467682195
  NPD
• St Dominic Medical Associates LLC

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1285987578
  NPD
• St. Dominic Medical Associates LLC

  • Gastroenterology Physician
  • Jackson, MS
  • NPI 1902374085
  NPD
• St Dominic Medical Associates LLC

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1508263179
  NPD (past)

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

• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1114403268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "601-200-2637",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-2637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 River Oaks Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392329575",
            "country_code": "US",
            "telephone_number": "601-939-9923",
            "fax_number": "601-939-9924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "970 Lakeland Dr Ste 49",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164634",
            "country_code": "US",
            "telephone_number": "601-200-4850",
            "fax_number": "601-200-4838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GINN",
        "first_name": "KATHERINE",
        "middle_name": "PUCKETT",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902808",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08220070",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P02359034",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "688710",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Gillum
• Daniel Gilmer, M.D.
• Jackson Davis Gilmore
• Kimberly Alease Gilmore
• Niesha Lasha Gilmore, OTR/L
• Helen Denise Gipson, FNP
• Samantha Smith Gipson, AGNP-C
• Joann Giraud, PHAM.D
• Shankar Praharaju Girija Giri, M.D
• Cheryl Lynn Gladney, M.D.

• Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.