Katie Beth Gibbs
Individual provider Active NPI Nurse Practitioner · Petal, MS
NPI 1194662767 · NPPES record last updated Jul 17, 2026
Key facts
- NPI
- 1194662767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 908429 (MS)
- Practice address
- 50 Parkway LN Ste 100
Petal, MS 39465-3059 - Phone
- (601) 705-2897
- NPI assigned
- May 1, 2026
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
415 S 28TH Ave
Hattiesburg, MS 39401-7246
50 Pkwy LN
Suite 100
Petal, MS 39465
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 905640 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic, PA | Past | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 908429 | MS | |
| Nurse Practitioner | 363L00000X | 908429 | MS | Yes |
Addresses
Primary practice location
50 Parkway LN Ste 100
Petal, MS 39465-3059
Mailing address
46 Carriage Parke Dr
Purvis, MS 39475-6052
Phone (662) 825-4731
Other providers in Petal, MS
- G G Morrison LLC
- Shawnta Senice Gandy
- Lauren O'Neal Garner
- Allison Garrett
- Lillian Gibb
- Gibsons Pharmacy No3
- George Gillespie III
- Ted Gene Harden II
- Charles J. Harrell Jr.
- Mackenzie C Harris
All providers in Petal, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.