Individual provider Active NPI

Kathleen A Rhodes, NP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1346558574
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R741095 Issued in MS
Practice address
2500 N State St
Attention:School of Nursing, Mercy Delta Express Clinic
Jackson, MS 39216-4500
Phone
(601) 984-6257
Fax
(601) 984-6206
NPI assigned
Sep 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 R741095 MS Primary

Addresses

Primary practice location

2500 N State St
Attention:School of Nursing, Mercy Delta Express Clinic
Jackson, MS 39216-4500

Mailing address

2500 North State Street
Attention:School of Nursing, Mercy Delta Express Clinic
Jackson, MS 39216-4505
Phone (601) 984-6257

Other practice location 1

401 Baptist Dr Ste 206
Madison, MS 39110-2011
Phone (601) 969-6404

Other identifiers 1

IdentifierTypeStateIssuer
08630002MedicaidMS

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
I20110124000320 MS Practitioner - Nurse Practitioner 2062691066 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Jul 30, 2025 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346558574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "ATTENTION:SCHOOL OF NURSING, MERCY DELTA EXPRESS CLINIC",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164505",
            "telephone_number": "601-984-6257",
            "fax_number": "601-984-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "ATTENTION:SCHOOL OF NURSING, MERCY DELTA EXPRESS CLINIC",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6257",
            "fax_number": "601-984-6206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Baptist Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391102011",
            "country_code": "US",
            "telephone_number": "601-969-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHODES",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R741095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08630002",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.