Katherine Ross Flynn, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

902967 Issued in MS

Practice address

439 N Jackson St
Brookhaven, MS 39601-2952

Phone

(601) 835-9499

NPI assigned

Oct 1, 2018

Last updated

Oct 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KDMC Physician Clinics LLCGroup PAC ID 7012154495, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4

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.

• KDMC Physician Clinics LLC

  • Multi-Specialty Clinic/Center
  • Brookhaven, MS
  • NPI 1861739161
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1639654171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 HIGHWAY 51 N",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012350",
            "telephone_number": "601-833-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 N JACKSON ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012952",
            "telephone_number": "601-835-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "KATHERINE",
        "middle_name": "ROSS",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredericka Lynette Fairman
• Family Health Care Clinic, Inc
• Amanda Farish
• First Care Home Heath Agency LLC
• Courtney Fleming
• Focus Solutions Mental Health Resources LLC
• For Your Glory Cranial Prosthetics
• Kline Foster
• Freds Stores of Tennessee Inc (Freds Pharmacy 1171)
• Ellisann Claire McInnis Freeman, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.