Individual provider Active NPI

Katherine Broome Totty, F.N.P.

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1164856894
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R869835 Issued in MS
Practice address
970 Lakeland Dr Ste 61
Jackson, MS 39216-4682
Phone
(601) 982-7850
NPI assigned
Aug 29, 2013
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R869835 MS Primary

Addresses

Primary practice location

970 Lakeland Dr Ste 61
Jackson, MS 39216-4682

Mailing address

113 Green Gate Xing
Ridgeland, MS 39157-9454
Phone (601) 750-2190

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address katherine.tottynp.p1@direct.jacksonheart.nextgenshare.com

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
I20151228001506 MS Practitioner - Nurse Practitioner 7517268014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Heart Clinic. P.a.Group PAC ID 0547204091, 40 clinicians

Practice addresses (Care Compare)

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4634
Phone (601) 982-7850

Merit-based Incentive Payment System (MIPS)

Final score
86.07 of 100Reported as group
Quality
74.67
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R869835MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Heart Clinic. P.a. CurrentSince Jun 6, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
Trustcare Health, LLC PastSince Mar 1, 2015 Accepting new patients

Locations

185 Medical Pkwy
Ste 202
Flowood, MS 39232

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

970 Lakeland Dr
Ste 61
Jackson, MS 39216
Phone (601) 200-2780

326 Commerce Center Dr
Ste 2000
Ridgeland, MS 39157

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1164856894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 GREEN GATE XING",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391579454",
            "telephone_number": "601-750-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR STE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164682",
            "telephone_number": "601-982-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTTY",
        "first_name": "KATHERINE",
        "middle_name": "BROOME",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R869835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katherine.tottynp.p1@direct.jacksonheart.nextgenshare.com",
            "affiliation": "N",
            "address_1": "970 Lakeland Dr Ste 61",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.