Individual provider Active NPI

Katelyn Williams, AGACNP

  • Acute Care Nurse Practitioner
  • Pascagoula, MS
National Provider Identifier
1528899283
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
906871 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581-5301
Phone
(228) 217-5326
NPI assigned
Aug 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 906871 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581-5301

Mailing address

217 Tantallon Dr
Ocean Springs, MS 39564-9195
Phone (228) 217-5326

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
I20240923001038 MS Practitioner - Nurse Practitioner 2264973890 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906871MSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Sep 8, 2024 Accepting new patients
Singing River Health System CurrentSince Sep 8, 2024 Accepting new patients
Singing River Gulfport CurrentSince Sep 8, 2024 Accepting new patients
Singing River Gulfport CurrentSince Sep 8, 2024 Accepting new patients

Locations

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

1199 Ocean Springs Rd
Ocean Springs, MS 39564
Phone (228) 875-9363

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1528899283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 TANTALLON DR",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395649195",
            "telephone_number": "228-217-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-217-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATELYN",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "906871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.