Individual provider Active NPI

Katherine Marie Jett, FAMILY NURSE PRACT.

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1407854938
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R869652 Issued in MS
Practice address
1200 N State St # LL10
Jackson, MS 39202-2000
Phone
(601) 352-2273
Fax
(601) 714-3415
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 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 R869652 MS Primary

Addresses

Primary practice location

1200 N State St # LL10
Jackson, MS 39202-2000

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446
Phone (901) 227-3255

Other identifiers 1

IdentifierTypeStateIssuer
01489305MedicaidMS

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
I20100622000802 MS Practitioner - Nurse Practitioner 9234118084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N State St
Suite 500
Jackson, MS 39202-2027
Phone (601) 352-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Baptist Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Medical Foundation of Central Ms CurrentSince Oct 1, 2015 Accepting new patients

Locations

1490 W Government St
Ste 10
Brandon, MS 39042
Phone (601) 825-1936

1887 Spillway Rd
Brandon, MS 39047
Phone (601) 992-5532

106 Clinton Pkwy
Clinton, MS 39056
Phone (601) 924-9005

151 E Metro Dr
Ste 103
Flowood, MS 39232
Phone (601) 992-3288

102 Lexington Dr
#100
Gluckstadt, MS 39110
Phone (601) 973-1688

1200 N State St
#10
Jackson, MS 39202
Phone (601) 362-7280

501 Marshall St
Ste G7
Jackson, MS 39202
Phone (601) 292-4261

6250 Old Canton Rd
Ste 100
Jackson, MS 39211
Phone (601) 957-1015

501 Marshall St
Ste 104
Jackson, MS 39202
Phone (601) 973-4541

7275 S Siwell Rd
Jackson, MS 39272
Phone (601) 373-7722

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273

1200 N State St
Ste 480
Jackson, MS 39202
Phone (601) 352-2273

1200 N State St
Ste LL10
Jackson, MS 39202
Phone (601) 362-7280

2173 Main St
Madison, MS 39110
Phone (601) 605-3858

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

3011 Greenfield Rd
Pearl, MS 39208
Phone (601) 825-9000

1201 Highway 49 S
Ste 1
Richland, MS 39218
Phone (601) 326-8700

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

Interoperability endpoints

  • Direct secure messaging: kjett149032@direct.bmhcc.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1407854938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-227-3255",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST # LL10",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022000",
            "telephone_number": "601-352-2273",
            "fax_number": "601-714-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "FAMILY NURSE PRACT.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R869652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01489305",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.